Mackenzie Marie Mellum, PA

NPI #1699403543 in Farmington, Minnesota

Provider Information

NPI Number: 1699403543
Entity Type: Individual
Name: Mackenzie Marie Mellum, PA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA
Enumeration Date: Aug 9, 2022
Last Updated: Apr 27, 2023

Practice Location

Address: 21260 CHIPPENDALE AVE W
City: Farmington
State: Minnesota
ZIP Code: 55024-1427
Phone: (651) 463-7181

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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