Individual
MELISSA ANN MAKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
4899 MILLER TRUNK HWY STE 208, HERMANTOWN, MN 55811-1582
(218) 727-3888
(218) 260-4772
Mailing address
1702 MILLER TRUNK HWY STE 214, DULUTH, MN 55811-4443
(218) 727-3888
(218) 260-4772
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R128720-4
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
034023500
—
MN
Enumeration date
09/25/2006
Last updated
03/24/2021
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