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NPI Code Detail

MEDICARE: MRS. MELINDA KAY ROSE ARNP

MEDICARE: MRS. MELINDA KAY ROSE ARNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner2883WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
143958OTHERIAWELLMARK BCBS

General Provider Information

NPI Number : 1174517320
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MELINDA KAY ROSE ARNP
Provider Business Mailing Address
First Line : 7974 UW HEALTH CT
Second Line :
City : MIDDLETON
State : WI
Zip : 53562-5531
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 451 JUNCTION RD
Second Line :
City : MADISON
State : WI
Zip : 53717-2656
Country : US
Telephone Number : 608-265-7601
Fax Number : 608-265-7581
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/02/2005
Last Update Date : 04/29/2009

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