Individual
MELISSA R DHILLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
744 S WEBSTER AVE, 2ND FLOOR, GREEN BAY, WI 54301
(920) 433-3640
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7210
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3269-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1116989
NATIONAL COMMISSION OF CERTIFIED PHYSICIAN ASSIATANTS
—
Enumeration date
02/10/2014
Last updated
10/25/2022
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