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General NPI Number Information
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NPI Number | 1053782185
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Entity Type | Individual
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Provider Name | MELISSA LYNN LEOPOLD FNP-C
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Gender | Female
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Dates
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Enumeration Date | 10/15/2015
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 425 PINE RIDGE BLVD STE 220A
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City | WAUSAU
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State | WI
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Zip | 54401-4123
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Country | US
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Telephone | 715-847-2070
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Fax | 715-843-1343
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Provider Business Mailing Address
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Address Line | 2911 DEER RD
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City | WISCONSIN RAPIDS
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State | WI
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Zip | 54494-7427
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Country | US
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Telephone | 715-939-2451
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 12005-33
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License Number State | WI
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