Provider Demographics
NPI:1457647638
Name:DARLING, MELISA DAWN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MELISA
Middle Name:DAWN
Last Name:DARLING
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:755 53RD AVE NE
Mailing Address - Street 2:T-2200
Mailing Address - City:FRIDLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55421-1240
Mailing Address - Country:US
Mailing Address - Phone:763-852-0003
Mailing Address - Fax:
Practice Address - Street 1:755 53RD AVE NE
Practice Address - Street 2:T-2200
Practice Address - City:FRIDLEY
Practice Address - State:MN
Practice Address - Zip Code:55421-1240
Practice Address - Country:US
Practice Address - Phone:763-852-0003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-25
Last Update Date:2011-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN119493183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist