Individual
MELISSA ANN PETERSEN-GENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1220 W 12TH AVE, STILLWATER, OK 74074-4400
(405) 372-6120
Mailing address
1220 W 12TH AVE, STILLWATER, OK 74074-4400
(405) 372-6120
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14599
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14599
PHARMACIST LICENSE NUMBER
OK
Enumeration date
08/11/2020
Last updated
11/27/2023
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