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General NPI Number Information
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NPI Number | 1922314350
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Entity Type | Individual
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Provider Name | MELISSA ANN STEPCHUK NP-C
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Gender | Female
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Dates
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Enumeration Date | 08/23/2010
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 205 N EAST AVE
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City | JACKSON
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State | MI
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Zip | 49201-1753
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Country | US
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Telephone | 517-205-7289
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Fax | 517-205-1322
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Provider Business Mailing Address
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Address Line | PO BOX 67000 DEPARTMENT 272801 PROVIDER ENROLLMENT
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City | DETROIT
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State | MI
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Zip | 48267-2728
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Country | US
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Telephone | 517-205-6248
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Fax | 517-205-7419
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | A0211046
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License Number State | OH
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