Individual
MELISSA A WITZIGMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
400 N STATE OF FRANKLIN RD, JOHNSON CITY, TN 37604-6035
(423) 302-1200
(423) 302-1220
Mailing address
400 N STATE OF FRANKLIN RD, JOHNSON CITY, TN 37604-6035
(423) 302-1200
(423) 302-1220
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1846
TN
363A00000X
Physician Assistant
772-023
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005
BCBS
WI
05
—
1520451
—
TN
05
—
42952100
—
WI
Enumeration date
12/21/2005
Last updated
07/05/2013
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