Most Relevant Information
Provider Data
| NPI Number: | 1003052556 |
| Provider Name: | MELISSA RICHARDSON PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | 10554 |
Most Important Dates
| Enumeration Date: | 01/05/2009 |
| Last Updated: | 09/05/2019 |
Provider Practice Location
420 DELAWARE ST SE
MINNEAPOLIS
MN
554550341
Practice Location Phone/Fax
| Phone: | 6122733000 |
| Fax: |
Provider Mailing Location
420 DELAWARE ST SE
MINNEAPOLIS
MN
554550341
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |