MRS. MELISSA N MILLER (NPI# 1649588914) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649588914 |
| Entity Type | Individual |
| Full Name | MRS. MELISSA N MILLER |
| Other Name | MS. MELISSA N LIND |
| Credential | PA-C |
| Practice Address |
2809 N Park Drive Ln Appleton WI 54911-1603 |
| Practice Telephone | 9203804999 |
| Mailing Telephone | 9203804999 |
| Enumeration Date | 2010-09-20 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
4250 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
085003857 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BCBSIL GROUP | 10115176 | 01 |
| IL | MEDICARE GROUP PTAN | 769380 | 01 |
| IL | TRICARE | 363502461001 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2450 S. Golf Road, Suite F, Westchester, IL 60154 | 7082738400 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053928853 | Melissa Miller | Audiologist-Hearing Aid Fitter | 14877 W Bell Rd Ste 101, Surprise, AZ 85374-7610 | 2020-09-25 |
| 1265042527 | Melissa Miller | Behavioral Analyst | 900 Old Austin Hutto Rd Ste 320, Pflugerville, TX 78660-6006 | 2020-08-03 |
| 1093347536 | Melissa Olivia Miller | Specialist/Technologist | 221 Charlotte Ave, Suffolk, VA 23434-5452 | 2020-02-11 |
| 1275181109 | Melissa Grace Miller | Advanced Practice Midwife | 2101 Adelbert Rd, Cleveland, OH 44106-2624 | 2019-09-04 |
| 1114570736 | Melissa Ann Miller | Case Manager/Care Coordinator | 103 Cedar Hill Rd, Lancaster, OH 43130-3637 | 2019-07-23 |
| 1902469612 | Melissa Marie Miller | Behavior Technician | 636 Huntington Ln, Allen, TX 75002-5816 | 2019-04-18 |
| 1871001651 | Melissa Kay Miller | Social Worker | 1300 W Rosedale St Ste 8, Fort Worth, TX 76104-2826 | 2018-01-16 |
| 1417479544 | Melissa Ann Miller | Nurse Practitioner | 3333 Burnet Ave # Mlc2017, Cincinnati, OH 45229-3026 | 2017-07-11 |
| 1699295824 | Melissa Samantha Miller | Massage Therapist | 18933 59th Ave Ne Spc 114, Arlington, WA 98223-6316 | 2017-06-20 |
| 1902344252 | Melissa Miller | Counselor | 2962 Southwest 26th Terrace, 204, Fort Lauderale, FL 33312 | 2017-02-07 |
| Street Address |
2809 N PARK DRIVE LN |
| City | APPLETON |
| State | WI |
| Zip Code | 54911-1603 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205897279 | Laura Ann Madson | Physician Assistant | 2809 N Park Drive Ln, Appleton, WI 54911-1603 | 2006-03-30 |
| 1265940365 | Brent A Martin | Registered Nurse | 2809 N Park Drive Ln, Appleton, WI 54911-1603 | 2018-01-11 |
| 1427421783 | Jessica E Radtke | Nurse Practitioner | 2809 N Park Drive Ln, Appleton, WI 54911-1603 | 2015-11-09 |
| 1083003826 | Michelle A Wilke | Counselor | 2809 N Park Drive Ln, Appleton, WI 54911-1603 | 2015-01-16 |
| 1336544972 | Darya Quandt | Counselor | 2809 N Park Drive Ln, Appleton, WI 54911-1603 | 2014-10-24 |
| 1972936789 | Stephanie R Smith | Physical Therapist | 2809 N Park Drive Ln, Appleton, WI 54911-1603 | 2013-08-15 |
| 1669646071 | Dia M Welch | Nurse Practitioner | 2809 N Park Drive Ln, Appleton, WI 54911-1603 | 2008-04-16 |
| 1962595249 | Bridget S Huenink | Nurse Practitioner | 2809 N Park Drive Ln, Appleton, WI 54911-1603 | 2006-10-01 |
| 1508959883 | Bonnie L Nickasch | Nurse Practitioner | 2809 N Park Drive Ln, Appleton, WI 54911-1603 | 2006-10-01 |
| 1376656959 | Thedacare, Incorporated | Family Medicine | 2809 N Park Drive Ln, Appleton, WI 54911-1603 | 2006-08-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912545633 | Brotherly Love, LLC | Day Training, Developmentally Disabled Services | 1513 E Frances St, Appleton, WI 54911 | 2019-12-12 |
| 1952952129 | Eagle Point Senior Living Inc | Assisted Living Facility | 995 East John Street, Appleton, WI 54911 | 2019-09-27 |
| 1619524766 | University Rx LLC | Pharmacy | 133 E College Ave, Appleton, WI 54911 | 2019-08-23 |
| 1174080063 | Shayla Russell | Counselor | Outagamie County Health and Human Services, 320 S. Walnut St., Appleton, WI 54911 | 2019-02-27 |
| 1871086645 | Megan Kilsdonk | Health Educator | 1604 N Meade St, Appleton, WI 54911 | 2018-06-07 |
| 1871085480 | Tanya Lynn Vickery | Social Worker | 410 S. Elm St., Appleton, WI 54911 | 2018-05-31 |
| 1013407501 | Teri G Metropulos | Counselor | 229 S. Morrison, Appleton, WI 54911 | 2018-05-10 |
| 1093211211 | Bonnie Anne Korytkowski | Student in an Organized Health Care Education/Training Program | 229 S. Morrison Street, Appleton, WI 54911 | 2018-04-05 |
| 1639673940 | Brett Follett | Psychologist | 401 S. Elm St., Appleton, WI 54911 | 2018-03-21 |
| 1700202892 | Brian Withrow | Counselor | 607 West 7th St., Appleton, WI 54911 | 2014-03-13 |
| Find all providers in zip 54911 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770772949 | Rebecca A Lehman | Physician Assistant | 1818 N Meade St, Appleton, WI 54911-3454 | 2007-10-23 |
| 1629107412 | Wanda L Vanderwyst | Physician Assistant | 1818 N Meade St, Appleton, WI 54911-3454 | 2007-03-05 |
| 1376616417 | Christina M Carnes | Physician Assistant | 3916 N Intertech Ct, Appleton, WI 54913 | 2006-11-16 |
| 1982792305 | Jennifer Marie Langman Reese | Physician Assistant | 1818 N Meade St, Appleton, WI 54911 | 2006-10-11 |
| 1184643827 | Jane Annette Peterson | Physician Assistant | 10 Tri Park Way, Appleton, WI 54914-1658 | 2006-07-19 |
| 1831199439 | Craig Quandt-walle | Physician Assistant | 1818 N Meade St, Appleton, WI 54911-3454 | 2005-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093348542 | Christopher Sean Lanctin | Physician Assistant | 557 N 17th St Apt 310, Milwaukee, WI 53233-2128 | 2020-02-12 |
| 1750936068 | Javier Eugenio Font | Physician Assistant | 813 N Clover Ln, Cottage Grove, WI 53527-9433 | 2019-08-04 |
| 1962056432 | Lyndsey Marie Bratberg | Physician Assistant | F&mcw Clinical Cancer Center 9200 W. Wisconsin Ave., Milwaukee, WI 53226 | 2019-08-01 |
| 1588225544 | Hannah Elizabeth Krum | Physician Assistant | S80w17784 Brennan Dr, Muskego, WI 53150-8828 | 2019-06-21 |
| 1255825162 | Katelyn Marie Frankwick | Physician Assistant | 1011 E Spruce St # 6, Abbotsford, WI 54405-9647 | 2018-06-15 |
| 1831644228 | Megan E Nelson | Physician Assistant | 221 E Mills Dr, Lake Mills, WI 53551-1910 | 2016-08-16 |
| 1356717904 | Amy Hermus | Physician Assistant | 451 Butternut Dr, Oregon, WI 53575-1349 | 2015-08-18 |
| 1497168066 | Alexander J Hill | Physician Assistant | 1111 North Road, Mauston, WI 53948-0700 | 2014-06-11 |
| 1487083242 | Andrew John Miller | Physician Assistant | 1521 Lakeview Ave, Wausau, WI 54401-6168 | 2013-11-02 |
| 1386944502 | Bethany Rose Yard | Physician Assistant | 18601 Lincoln Street, Whitehall, WI 54773 | 2010-10-22 |
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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.