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General NPI Number Information
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NPI Number | 1891129482
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Entity Type | Individual
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Provider Name | MELISSA ANNE DAVEY FNP-C
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Gender | Female
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Dates
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Enumeration Date | 08/30/2013
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Last Update Date | 04/09/2019
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Provider Practice Location Address
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Address Line | 125 HOSPITAL DR
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City | WATERTOWN
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State | WI
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Zip | 53098
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Country | US
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Telephone | 920-262-4825
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Fax |
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Provider Business Mailing Address
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Address Line | 1025 MULBERRY ST
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City | LAKE MILLS
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State | WI
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Zip | 53551-1304
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Country | US
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Telephone | 920-648-4518
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Fax | 920-648-1623
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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 | 9030-33
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | 197134-30
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License Number State | WI
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