Individual
MELANIE CARLISLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
601 JOHN ST, BOX 74, KALAMAZOO, MI 49007-5341
(269) 341-8481
(269) 341-7781
Mailing address
601 JOHN ST, BOX 74, KALAMAZOO, MI 49007-5341
(269) 341-8481
(269) 341-7781
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601004849
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
160C976180
BCBSM
MI
05
—
1811060163
—
MI
Enumeration date
11/16/2006
Last updated
11/07/2014
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