Healthcare Provider Details

I. General information

NPI: 1528978632
Provider Name (Legal Business Name): MELISSA J LUNA SALAZAR NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1032 S 16TH ST
MILWAUKEE WI
53204-2203
US

IV. Provider business mailing address

1136 S 8TH ST
MILWAUKEE WI
53204-2332
US

V. Phone/Fax

Practice location:
  • Phone: 414-672-1353
  • Fax: 262-408-5094
Mailing address:
  • Phone: 414-306-2481
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number19178-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: