Provider Demographics
NPI:1962800078
Name:YARBER, MELYNNI
Entity type:Individual
Prefix:
First Name:MELYNNI
Middle Name:
Last Name:YARBER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 PREACHER ROE BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST PLAINS
Mailing Address - State:MO
Mailing Address - Zip Code:65775-2938
Mailing Address - Country:US
Mailing Address - Phone:417-256-7114
Mailing Address - Fax:417-257-2819
Practice Address - Street 1:1310 PREACHER ROE BLVD
Practice Address - Street 2:
Practice Address - City:WEST PLAINS
Practice Address - State:MO
Practice Address - Zip Code:65775-2938
Practice Address - Country:US
Practice Address - Phone:417-256-7114
Practice Address - Fax:417-257-2819
Is Sole Proprietor?:No
Enumeration Date:2014-12-05
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004031554183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist