Provider Demographics
NPI:1962005116
Name:MORRISSETTE, MELISSA GIRACCA (RPH)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:GIRACCA
Last Name:MORRISSETTE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 FEATHERBED LN
Mailing Address - Street 2:
Mailing Address - City:SOUTH HERO
Mailing Address - State:VT
Mailing Address - Zip Code:05486-4001
Mailing Address - Country:US
Mailing Address - Phone:413-552-9826
Mailing Address - Fax:
Practice Address - Street 1:259 US ROUTE 7 S
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:VT
Practice Address - Zip Code:05468-3868
Practice Address - Country:US
Practice Address - Phone:802-893-0714
Practice Address - Fax:802-893-1196
Is Sole Proprietor?:No
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH24296183500000X
VT033.0121156183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist