Provider Demographics
NPI:1477848893
Name:MELL, ANN M (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:M
Last Name:MELL
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 1:5418 SAINT CROIX TRL STE 102
Mailing Address - Street 2:
Mailing Address - City:NORTH BRANCH
Mailing Address - State:MN
Mailing Address - Zip Code:55056-4211
Mailing Address - Country:US
Mailing Address - Phone:651-243-5325
Mailing Address - Fax:651-243-5324
Practice Address - Street 1:5418 SAINT CROIX TRL STE 102
Practice Address - Street 2:
Practice Address - City:NORTH BRANCH
Practice Address - State:MN
Practice Address - Zip Code:55056-4211
Practice Address - Country:US
Practice Address - Phone:651-243-5325
Practice Address - Fax:651-243-5324
Is Sole Proprietor?:No
Enumeration Date:2011-06-14
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN116148183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist