Provider Demographics
NPI:1013137645
Name:OSBORNE, MELISSA RAE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:RAE
Last Name:OSBORNE
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 1:10213 N WYANDOTTE ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64155-3509
Mailing Address - Country:US
Mailing Address - Phone:816-806-6251
Mailing Address - Fax:
Practice Address - Street 1:10213 N WYANDOTTE ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64155-3509
Practice Address - Country:US
Practice Address - Phone:816-806-6251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA16913183500000X
MO20030314521835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered183500000XPharmacy Service ProvidersPharmacist
Not Answered1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy