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General NPI Number Information
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NPI Number | 1699649798
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Entity Type | Individual
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Provider Name | MELISSA KAY HASKINS FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 10/01/2025
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Last Update Date | 10/03/2025
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Provider Practice Location Address
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Address Line | 710 RIVERSIDE DR
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City | WAUPACA
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State | WI
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Zip | 54981-1941
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Country | US
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Telephone | 715-256-3000
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Fax |
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Provider Business Mailing Address
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Address Line | N625 COUNTY ROAD U
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City | WEYAUWEGA
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State | WI
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Zip | 54983-4008
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Country | US
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Telephone | 920-574-6998
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 17514-33
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 17514
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License Number State | WI
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