MS. MELODY A FOWLKES (NPI# 1194830257) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194830257 |
| Entity Type | Individual |
| Full Name | MS. MELODY A FOWLKES |
| Credential | APNP |
| Practice Address |
12122 N Rolling Field Dr Mequon WI 53097-2766 |
| Practice Telephone | 2622422283 |
| Practice Fax Number | 2622422156 |
| Mailing Telephone | 2622422283 |
| Mailing Fax Number | 2622422156 |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2008-04-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 1462-033 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363L00000X | Nurse Practitioner | 80518-030 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
12122 N ROLLING FIELD DR |
| City | MEQUON |
| State | WI |
| Zip Code | 53097-2766 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851512982 | Wendy S Balister | Dietitian, Registered | 13111 North Port Washington Rd, Mequon, WV 53097 | 2007-05-02 |
| 1902985922 | Lisa Lang | Counselor | 14135 North Cedarburg Road, Mequon, WI 53097 | 2006-11-02 |
| 1003915570 | Joan T Gnadt | Internal Medicine | 13133 N Port Washington Rd., Suite 111, Mequon, WI 53097 | 2006-09-21 |
| 1255439097 | Susan J Riegg | Pathology | 13111 N Port Washington Road, Mequon, WI 53097 | 2006-09-20 |
| 1891808887 | Gregory Eric Custer | Dentist | 13615 N Cedarburg Road, Mequon, WI 53097 | 2006-08-16 |
| 1114958600 | Richard K Karr | Orthopaedic Surgery | 13133n Port Washington Road, #216, Mequon, WI 53097 | 2006-07-05 |
| 1548204712 | Lauretta Lyon Schears | Occupational Therapist | 13111 N. Portwashington Rd, Mequon, WI 53097 | 2006-06-16 |
| 1235173337 | Sarah Marie Neman | Physical Therapy Assistant | 13111 N Prot Washington Rd., Mequon, WI 53097 | 2006-06-16 |
| 1538103643 | Elizabeth Gral Sullivan | Speech-Language Pathologist | 13111 North Port Washington Road, Mequon, WI 53097 | 2006-06-16 |
| 1952808701 | Lisa Lang LLC | Counselor | 14135 North Cedarburg Road, Mequon, WI 53097 | 2018-04-09 |
| Find all providers in zip 53097 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851713739 | Sheila A Reynolds | Nurse Practitioner | 11300 N Revere Rd, Mequon, WI 53092-3555 | 2014-01-13 |
| 1861737108 | Sarah J Escareno | Nurse Practitioner | 6400 W Enterprise Dr Fl 1, Mequon, WI 53092-4400 | 2012-11-27 |
| 1083681332 | Kristen E Lachapell | Nurse Practitioner | 6425 W Mequon Rd, Mequon, WI 53092-1855 | 2006-03-07 |
| 1053839571 | Annette S Harris | Nurse Practitioner | 12203 Corporate Pkwy, Mequon, WI 53092-3388 | 2017-09-05 |
| 1508306671 | Philip W Diperna | Nurse Practitioner | 13111 N Port Washington Rd, Mequon, WI 53097-2416 | 2017-03-08 |
| 1851833735 | Vyacheslav Dubrovsky | Nurse Practitioner | 1317 W Towne Square Rd, Mequon, WI 53092-5017 | 2016-11-09 |
| 1326417874 | Crystal M Steinhardt | Nurse Practitioner | 11270 N Port Washington Rd, Mequon, WI 53092-3410 | 2015-09-15 |
| 1770968521 | Patricia Kay Nelson | Nurse Practitioner | 13133 N Port Washington Rd, Suite G-18, Mequon, WI 53097-2419 | 2015-07-22 |
| 1477947935 | Britani R Weidman | Nurse Practitioner | 6425 W Mequon Rd, Mequon, WI 53092-1855 | 2015-03-23 |
| 1336540418 | Andrea R Enters | Nurse Practitioner | 6425 W Mequon Rd, Mequon, WI 53092-1855 | 2014-09-09 |
| Find all providers in MEQUON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.