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General NPI Number Information
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NPI Number | 1316375363
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Entity Type | Individual
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Provider Name | MELYSSA HEINTZ FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 10/29/2013
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Last Update Date | 07/10/2023
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Provider Practice Location Address
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Address Line | 720 2ND AVE
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City | EAU CLAIRE
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State | WI
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Zip | 54703-5413
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Country | US
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Telephone | 715-839-6988
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Fax |
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Provider Business Mailing Address
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Address Line | 967 W CLAIREMONT AVE
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City | EAU CLAIRE
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State | WI
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Zip | 54701-6103
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Country | US
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Telephone | 715-833-0227
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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 | 146678-30
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License Number State | WI
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