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General NPI Number Information
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NPI Number | 1821499740
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Entity Type | Individual
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Provider Name | MELINDA HOLLY ALTMAN ARNP
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Gender | Female
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Dates
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Enumeration Date | 09/10/2014
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Last Update Date | 08/16/2023
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Provider Practice Location Address
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Address Line | N7135 ROCKY KNOLL PKWY
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City | PLYMOUTH
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State | WI
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Zip | 53073-3103
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Country | US
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Telephone | 630-571-8990
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Fax |
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Provider Business Mailing Address
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Address Line | N7135 ROCKY KNOLL PKWY
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City | PLYMOUTH
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State | WI
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Zip | 53073-3103
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Country | US
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Telephone | 630-571-8990
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | A097345
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 11869
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License Number State | WI
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