Individual
MELISSA WILCOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2524 HANNAH AVE NW, BEMIDJI, MN 56601-2110
(218) 210-2100
Mailing address
2524 HANNAH AVE NW, BEMIDJI, MN 56601-2110
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
751906
MN
Other
Enumeration date
08/21/2024
Last updated
08/21/2024
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