Healthcare Provider Details

I. General information

NPI: 1912436460
Provider Name (Legal Business Name): MELINDA SCHAITEL FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2017
Last Update Date: 07/21/2022
Certification Date: 01/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2727 MIDWEST DR.
ONALASKA WI
54650
US

IV. Provider business mailing address

2727 MIDWEST DR.
ONALASKA WI
54650
US

V. Phone/Fax

Practice location:
  • Phone: 608-782-2027
  • Fax: 608-782-6172
Mailing address:
  • Phone: 608-782-2027
  • Fax: 608-782-6172

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024174529
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN275883
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: