1538520432 NPI number — MELISSA PROFFITT LEBAR PHARMD

Table of content: MELISSA PROFFITT LEBAR PHARMD (NPI 1538520432)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538520432 NPI number — MELISSA PROFFITT LEBAR PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LEBAR
Provider First Name:
MELISSA
Provider Middle Name:
PROFFITT
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PROFFITT
Provider Other First Name:
MELISSA
Provider Other Middle Name:
DAWN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1538520432
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/17/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3215 NOTTINGHAM CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAWRENCE
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66049-8906
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
785-550-7742
Provider Business Mailing Address Fax Number:
785-331-0878

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
335 SW MACVICAR AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TOPEKA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66606-2441
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-379-2341
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/19/2016

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  1-12154 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 416708 . This is a "NABP" identifier . This identifiers is of the category "OTHER".




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