Individual
MELISSA RENEE NOWICKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3305 S 20TH ST, MILWAUKEE, WI 53215-4940
(414) 645-1808
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(414) 645-1808
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4775-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100003355
—
WI
Enumeration date
04/27/2012
Last updated
02/01/2024
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