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General NPI Number Information
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NPI Number | 1962705707
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Entity Type | Individual
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Provider Name | MELISSA KATHERINE CODY ACNP-BC
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Gender | Female
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Dates
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Enumeration Date | 12/17/2010
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Last Update Date | 07/24/2023
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Provider Practice Location Address
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Address Line | 10000 W BLUEMOUND RD
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City | WAUWATOSA
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State | WI
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Zip | 53226-4321
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Country | US
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Telephone | 414-374-6624
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Fax |
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Provider Business Mailing Address
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Address Line | 10000 W BLUEMOUND RD
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City | WAUWATOSA
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State | WI
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Zip | 53226-4321
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Country | US
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Telephone | 141-437-4662
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 4298-33
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | AP124052
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License Number State | TX
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