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General NPI Number Information
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NPI Number | 1992961429
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Entity Type | Individual
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Provider Name | MELINDA SUE PARKER PA-C
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Gender | Female
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Dates
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Enumeration Date | 08/04/2008
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 1575 20TH ST NW STE 201
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City | FARIBAULT
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State | MN
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Zip | 55021-2933
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Country | US
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Telephone | 651-633-6883
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Fax | 651-331-3459
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Provider Business Mailing Address
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Address Line | 2720 FAIRVIEW AVE N STE 200
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City | ROSEVILLE
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State | MN
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Zip | 55113-1306
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Country | US
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Telephone | 651-633-6883
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Fax | 651-331-3459
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA60193376
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 2630
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 11555
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License Number State | MN
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