Mcculley, Melissa J

Mcculley, Melissa J is an individual health care provider with primary practice located at 2553 Kirsten Ln S # 202 , Fargo ND 58104-4901. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Mcculley, Melissa J can be contacted via phone (701) 373-2020.

Contact Information

Primary practice address
2553 Kirsten Ln S # 202 Fargo ND 58104-4901
Phone: (701) 373-2020
Fax: (701) 373-0021
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X ND597 North Dakota
Eye and Vision Services Providers / Optometrist 152W00000X 2824 Minnesota

Profile Details

NPI number 1912023714
LBN Legal business name Mcculley, Melissa J
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 22nd, 2007
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912023714 NPPES
Minnesota Other 88G84MC BLUE SHIELD
Minnesota Other 026373 BLUE SHIELD

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