Organization
NORTHERN WATERS CLINIC
Active
Other names
Northern Waters Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MELISSA ANN MAKI NP (CO-OWNER)
(218) 727-3888
Entity
Organization
Contact information
Practice address
4899 MILLER TRUNK HWY STE 208, HERMANTOWN, MN 55811-1582
(218) 391-9860
(218) 391-9860
Mailing address
1702 MILLER TRUNK HWY STE 214, DULUTH, MN 55811-4448
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
2318
MN
163WP0808X
Psychiatric/Mental Health Registered Nurse
2318
MN
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1295014520
—
MN
Enumeration date
01/23/2018
Last updated
12/04/2025
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