1558883231 NPI number — MRS. MELANIE DAWN DREIER PHARMD

Table of content: MRS. MELANIE DAWN DREIER PHARMD (NPI 1558883231)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558883231 NPI number — MRS. MELANIE DAWN DREIER PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DREIER
Provider First Name:
MELANIE
Provider Middle Name:
DAWN
Provider Name Prefix Text:
MRS.
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:
HANSON
Provider Other First Name:
MELANIE
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:
1558883231
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/21/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
N6520 LUMBERJACK GUY RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BLACK RIVER FALLS
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
54615-5405
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
715-284-9851
Provider Business Mailing Address Fax Number:
715-284-2293

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
N6520 GUY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BLACK RIVER FALLS
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
54615-5546
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
715-284-9851
Provider Business Practice Location Address Fax Number:
715-284-2293
Provider Enumeration Date:
07/13/2017

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: 1835P1200X , with the licence number:  18845-40 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 183500000X , with the licence number: 18845-40 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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