Provider Information for 1962160234
The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.
Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know
MELISSA MADRIAGA
Sex: Female
NPI: 1962160234
Last Updated: 2021-12-03
Certification Date: 2021-12-03
Certification Date: 2021-12-03
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1962160234 | ||||||||
| Enumeration Date | 2021-12-03 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | PO BOX 303 KEWASKUM, WI 53040-0303 United States Phone: 920-960-5890 | Fax: | ||||||||
| Primary Practice Address | 314 1ST ST KEWASKUM, WI 53040-8930 United States Phone: 920-960-5890 | Fax: | ||||||||
| Secondary Practice Address(es) | |||||||||
| Health Information Exchange |
| ||||||||
| Other Identifiers |
| ||||||||
| Taxonomy |
|