Individual
MELODY W HENRY
Active
Individual
MELODY W HENRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
7026-23
WV
363AM0700X
Medical Physician Assistant
Primary
7026
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1598411506
—
WI
Enumeration date
02/28/2022
Last updated
03/13/2025
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