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NPI 1619896099

NPI 1619896099 : MELISSA MARIE HAMACHEK PMHNP : GREEN BAY, WI

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General NPI Number Information
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    NPI Number           |    1619896099
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    Entity Type          |    Individual 
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    Provider Name        |    MELISSA MARIE HAMACHEK PMHNP
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/10/2026
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    Last Update Date     |    07/10/2026
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Provider Practice Location Address
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    Address Line         |    1048 GLORY RD STE A 
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    City                 |    GREEN BAY
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    State                |    WI
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    Zip                  |    54304-5664
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    Country              |    US
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    Telephone            |    920-238-8155
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    Fax                  |    920-214-1259
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Provider Business Mailing Address
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    Address Line         |    1048 GLORY RD STE A 
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    City                 |    GREEN BAY
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    State                |    WI
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    Zip                  |    54304-5664
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    Country              |    US
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    Telephone            |    920-238-8155
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    Fax                  |    920-214-1259
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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        |    363LP0808X
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    Taxonomy Name        |    Psychiatric/Mental Health Nurse Practitioner
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    License Number       |    18684-33
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    License Number State |    WI
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