Provider Demographics
NPI:1336269331
Name:JANSZEN, MELISSA M (RPH)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:M
Last Name:JANSZEN
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 1:8106 HARMS HILL DR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-9684
Mailing Address - Country:US
Mailing Address - Phone:859-746-9664
Mailing Address - Fax:
Practice Address - Street 1:105 SPEARS LN
Practice Address - Street 2:
Practice Address - City:CRITTENDEN
Practice Address - State:KY
Practice Address - Zip Code:41030-7513
Practice Address - Country:US
Practice Address - Phone:859-428-0900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0011097183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist