1386400117 NPI number — MELISSA MAY MELCHER DNP, MN, RN, FNP-BC

Table of content: MELISSA MAY MELCHER DNP, MN, RN, FNP-BC (NPI 1386400117)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386400117 NPI number — MELISSA MAY MELCHER DNP, MN, RN, FNP-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MELCHER
Provider First Name:
MELISSA
Provider Middle Name:
MAY
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DNP, MN, RN, FNP-BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1386400117
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/15/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3400 N CRAMER ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MILWAUKEE
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
53211-2815
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
224-210-0404
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2510 E CAPITOL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHOREWOOD
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53211-2136
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
414-975-8106
Provider Business Practice Location Address Fax Number:
908-520-4137
Provider Enumeration Date:
02/28/2024

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  220941-30 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363L00000X , with the licence number: 15170-33 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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