Individual
MISS MELISSA MARY MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
N1508 SHARI LN, FORT ATKINSON, WI 53538-9381
(920) 723-1823
Mailing address
N1508 SHARI LN, FORT ATKINSON, WI 53538-9381
(920) 723-1823
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
306805-031
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
35061500
—
WI
Enumeration date
12/09/2008
Last updated
12/09/2008
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