Individual
MRS. MELISSA MARIE WHITEHOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
2901 W KINNICKINNIC RIVER PKWY, MILWAUKEE, WI 53215-3677
(414) 649-5646
Mailing address
N47W27547 LYNNDALE RD, PEWAUKEE, WI 53072-1751
(414) 628-8751
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3788-23
WI
Other
Enumeration date
07/13/2016
Last updated
11/23/2021
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