Individual
MELLISSA C WILLMING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
320 S WALNUT ST, APPLETON, WI 54911-5918
(920) 843-5973
(414) 622-3869
Mailing address
320 S WALNUT ST, APPLETON, WI 54911-5918
(920) 843-5873
(414) 622-3869
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
7680
WI
363LF0000X
Family Nurse Practitioner
7680-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100067789
—
WI
Enumeration date
05/22/2007
Last updated
10/09/2023
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