Provider Demographics
NPI:1710586185
Name:CADE, MELANIE (RPH)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:CADE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3035 DENMARK AVE
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55121-2257
Mailing Address - Country:US
Mailing Address - Phone:651-405-3879
Mailing Address - Fax:
Practice Address - Street 1:3035 DENMARK AVE
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55121-2257
Practice Address - Country:US
Practice Address - Phone:651-405-3879
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-18
Last Update Date:2020-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN117093183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist