Healthcare Provider Details

I. General information

NPI: 1326854332
Provider Name (Legal Business Name): MELISSA DARLING EARNEST FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2024
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1755 SW BAKER ST
MCMINNVILLE OR
97128-9112
US

IV. Provider business mailing address

1755 SW BARNES ST.
MCMINNVILLE OR
97128
US

V. Phone/Fax

Practice location:
  • Phone: 971-900-4522
  • Fax:
Mailing address:
  • Phone: 971-900-4522
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number10036244
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: