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General NPI Number Information
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NPI Number | 1295807873
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Entity Type | Individual
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Provider Name | MELISSA ANN ROBERTSON PHARM.D
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Gender | Female
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 530 S JACKSON ST
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City | LOUISVILLE
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State | KY
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Zip | 40202-1675
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Country | US
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Telephone | 502-562-3436
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Fax |
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Provider Business Mailing Address
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Address Line | 6131 SWEETBAY DR
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City | CRESTWOOD
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State | KY
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Zip | 40014-7728
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Country | US
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Telephone | 502-409-5721
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 012971
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License Number State | KY
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