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General NPI Number Information
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NPI Number | 1740797133
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Entity Type | Individual
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Provider Name | MELISSA ANN JOHNSON PMHNP
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Gender | Female
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Dates
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Enumeration Date | 01/07/2018
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Last Update Date | 04/09/2025
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Provider Practice Location Address
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Address Line | 2717 N GRANDVIEW BLVD STE 102
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City | WAUKESHA
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State | WI
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Zip | 53188-1672
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Country | US
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Telephone | 877-906-9699
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Fax | 888-483-0118
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Provider Business Mailing Address
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Address Line | 1635 N WATER ST APT 524
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City | MILWAUKEE
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State | WI
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Zip | 53202-3661
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Country | US
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Telephone | 469-597-3335
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Fax | 888-483-0118
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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 | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 204104
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 23867
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP140019
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 16318-33
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License Number State | WI
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