MELISSA A DERCKS (NPI# 1710202577) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710202577 |
| Entity Type | Individual |
| Full Name | MELISSA A DERCKS |
| Credential | APNP |
| Practice Address |
725 S Webster Ave Suite 201 Green Bay WI 54301-3500 |
| Mailing Address |
Po Box 22487 Green Bay WI 54305-2487 |
| Practice Telephone | 9204307100 |
| Practice Fax Number | 9204307114 |
| Mailing Telephone | 9204457222 |
| Mailing Fax Number | 9204457289 |
| Enumeration Date | 2010-04-05 |
| Last Update Date | 2020-03-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
4010-33 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | LICENSE | 4010-33 | 01 |
| Street Address |
725 S WEBSTER AVE SUITE 201 |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54301-3500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326090697 | Richard L Erdman | Emergency Medicine | 725 S Webster Ave, Green Bay, WI 54301-3500 | 2006-05-16 |
| 1548807282 | Kate S Laurin | Nurse Practitioner | 725 S Webster Ave, Green Bay, WI 54301-3500 | 2019-12-02 |
| 1871155879 | Torri L Pulley | Speech-Language Pathologist | 725 S Webster Ave, Green Bay, WI 54301-3500 | 2019-07-01 |
| 1609354513 | Brittany A Barrette | Registered Nurse | 725 S Webster Ave, Green Bay, WI 54301-3500 | 2018-08-02 |
| 1184149965 | Alexandria M Caelwaerts | Physical Therapist | 725 S Webster Ave, Green Bay, WI 54301-3500 | 2017-08-14 |
| 1649706862 | Bellin Memorial Hospital Inc | Internal Medicine | 725 S Webster Ave, Suite 303, Green Bay, WI 54301-3500 | 2017-05-08 |
| 1770030157 | Rebekah R Vandewalle | Nurse Practitioner | 725 S Webster Ave, Green Bay, WI 54301-3500 | 2016-09-02 |
| 1225420664 | Bellin Memorial Hospital Inc | Psychiatry & Neurology | 725 S Webster Ave, Suite 201, Green Bay, WI 54301-3500 | 2015-02-23 |
| 1861824948 | Nicole E Hansen | Nurse Practitioner | 725 S Webster Ave, The Neuro Team, Green Bay, WI 54301-3500 | 2013-07-31 |
| 1083059034 | Megan C Brzezinski | Registered Nurse | 725 S Webster Ave, Suite 201, Green Bay, WI 54301-3500 | 2013-05-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386102465 | Parc Village Dental, LLC | Dentist | 2805 Libal Street, Suite A, Green Bay, WI 54301 | 2019-03-07 |
| 1598229478 | Shaina Marie Conner | Registered Nurse | 835 S Vanburen St, Green Bay, WI 54301 | 2019-01-25 |
| 1093298960 | Brown County | Case Management | 111 N. Jefferson Street, Green Bay, WI 54301 | 2018-09-07 |
| 1639609928 | Frontline Healthcare LLC | Specialist/Technologist, Other | 2221 S. Webster Ave. Suite 270, Greenbay, WI 54301 | 2017-06-19 |
| 1992242606 | Charmaine Rimple | Counselor | 526 South Monroe Avenue, Green Bay, WI 54301 | 2017-01-20 |
| 1962944819 | Rebecca Lucille Reinbold | Registered Nurse | 917 Catherine Street, Green Bay, WI 54301 | 2016-11-09 |
| 1730635061 | Melissa Kristof | Specialist/Technologist, Other | 1821 Sounth Webster Ave., Green Bay, WI 54301 | 2016-08-28 |
| 1255709747 | Vivian Sweetheart Bishop-cook | Counselor | 2920 South Webster Ave, Green Bay, WI 54301 | 2015-09-14 |
| 1881079960 | Chelsi S Weber | Registered Nurse | 2300 Riverside Dr., Ste 204, Green Bay, WI 54301 | 2015-07-30 |
| 1962816371 | Joelle M Hesse | Counselor | 630 Cherry St., Green Bay, WI 54301 | 2014-06-13 |
| Find all providers in zip 54301 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861871659 | Luis Vargas | Nurse Practitioner | 1630 Commanche Ave, Green Bay, WI 54313-5753 | 2015-05-26 |
| 1740446434 | Renee L Bohnart | Nurse Practitioner | 744 S Webster Ave, Green Bay, WI 54301-3505 | 2008-08-01 |
| 1992915318 | Amy Jo Emmer | Nurse Practitioner | 923 Eliza St, Green Bay, WI 54301-3234 | 2007-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952870289 | Sujata Karki | Nurse Practitioner | 402 N Eau Claire Ave Apt 309, Madison, WI 53705-2820 | 2018-11-15 |
| 1861926750 | Lisa Somers | Nurse Practitioner | W126n7338 Flint Dr, Menomonee Falls, WI 53051-4532 | 2017-04-17 |
| 1750828299 | Nanette Marie Kloth | Nurse Practitioner | 18110 W Bluemond Rd, Brookfield, WI 53045 | 2017-01-23 |
| 1902341852 | Rebecca Weld Hall | Nurse Practitioner | 3245 Milwaukee St, Madison, WI 53714-1829 | 2017-01-02 |
| 1629525613 | Katherine Simons Melde | Nurse Practitioner | 2222 S Park St Ste 210, Madison, WI 53713 | 2016-09-07 |
| 1134574643 | Victoria White | Nurse Practitioner | 2500 N Mayfair Rd Ste 260, Wauwatosa, WI 53226-1443 | 2016-05-03 |
| 1326414442 | Diane Marie Kelley | Nurse Practitioner | 300 Femrite Drive, Monona, WI 53716 | 2015-08-12 |
| 1841673829 | M Christine Meulemans | Nurse Practitioner | 3391 Wilderness Trl, Suamico, WI 54313-8746 | 2015-07-08 |
| 1548659725 | Patricia Ann Kender | Nurse Practitioner | 17495 W. Capitol Dr., Brookfield, WI 53045 | 2015-01-12 |
| 1588062947 | Laura Swett | Nurse Practitioner | 733 Woodside Dr, Seymour, WI 54165-1661 | 2014-12-16 |
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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.