Individual
MELISSA ROSE BENNETTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-AC
Contact information
Practice address
9000 W WISCONSIN AVE, WAUWATOSA, WI 53226-4874
(414) 266-4978
Mailing address
9000 W WISCONSIN AVE, WAUWATOSA, WI 53226-4874
Taxonomy
Speciality
Code
Description
License number
State
363LP0222X
Critical Care Pediatric Nurse Practitioner
Primary
20140378
WI
Other
Enumeration date
03/06/2014
Last updated
03/06/2014
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