| Doctor Name: | MELISSA JEAN GORACKE |
| NPI Number: | 1245582055 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.A. |
| License Number: | |
| Business Practice Address: | 3203 W. 3rd. Ave. Hibbing, MN - 55746 |
| Business Phone Number: | 2182639237 |
| Business Fax Number: | 2182623150 |
| Mailing Address: | 624 S. 13th St., P.o. Box 1188 VIRGINIA |
| State: | MN |
| Postal Code: | 55792 |
| Phone Number: | 2187492881 |
| Fax Number: | 2187493806 |
| NPI Enumeration Date: | 10/04/2012 |
| NPI Last Update Date: | 10/04/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 390200000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Student, Health Care |
| Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |