Individual
MELISSA CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-7342
(414) 805-7919
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-7342
(414) 805-7919
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2013005281
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1851721823
—
WI
Enumeration date
11/12/2013
Last updated
06/05/2021
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