Provider Demographics
NPI:1265429898
Name:ROBISON, MELISSA (CPHT)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:ROBISON
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1508 CANEY FORK CT
Mailing Address - Street 2:
Mailing Address - City:LA VERGNE
Mailing Address - State:TN
Mailing Address - Zip Code:37086-3069
Mailing Address - Country:US
Mailing Address - Phone:615-459-3411
Mailing Address - Fax:615-355-0629
Practice Address - Street 1:108 ENON SPRINGS RD
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37086
Practice Address - Country:US
Practice Address - Phone:615-459-3411
Practice Address - Fax:615-355-0629
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN13817183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician