Healthcare Provider Details

I. General information

NPI: 1326951245
Provider Name (Legal Business Name): MELISSA TESTOLIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 440
FLORENCE WI
54121-0440
US

IV. Provider business mailing address

5844 BILL ANDERSON DR
FLORENCE WI
54121-8822
US

V. Phone/Fax

Practice location:
  • Phone: 715-528-3262
  • Fax: 715-528-5910
Mailing address:
  • Phone: 815-715-1286
  • Fax: 715-528-5910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number256724-30
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: