Provider Demographics
NPI:1164728028
Name:ELLS, MELISSA A (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:A
Last Name:ELLS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 LABORE RD STE 104
Mailing Address - Street 2:
Mailing Address - City:VADNAIS HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55110-5186
Mailing Address - Country:US
Mailing Address - Phone:651-539-7200
Mailing Address - Fax:651-431-7505
Practice Address - Street 1:3200 LABORE RD STE 104
Practice Address - Street 2:
Practice Address - City:VADNAIS HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55110-5186
Practice Address - Country:US
Practice Address - Phone:651-539-7200
Practice Address - Fax:651-431-7505
Is Sole Proprietor?:No
Enumeration Date:2011-02-09
Last Update Date:2025-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1166291835P1200X, 1835P1300X
IA18682183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1300XPharmacy Service ProvidersPharmacistPsychiatric
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
No183500000XPharmacy Service ProvidersPharmacist