Provider Demographics
NPI:1437486503
Name:EISENSCHENK, MELISSA CARR
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:CARR
Last Name:EISENSCHENK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:NADINE
Other - Last Name:CARR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7723 FLYING CLOUD DR
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-3708
Mailing Address - Country:US
Mailing Address - Phone:952-946-0035
Mailing Address - Fax:
Practice Address - Street 1:7723 FLYING CLOUD DR
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55344-3708
Practice Address - Country:US
Practice Address - Phone:952-946-0035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-11
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN02202174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian