MEDICARE: MELANIE E RUETZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	24952530	WI
2	363LP0200X	Pediatric Nurse Practitioner	16910-33	WI

General Provider Information

NPI Number	:	1477413052
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELANIE E RUETZ

Provider Business Mailing Address
First Line	:	9000 W WISCONSIN AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53226-4874
Country	:	US
Telephone Number	:	414-266-2873
Fax Number	:

Provider Business Practice Location Address
First Line	:	9000 W WISCONSIN AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53226-4874
Country	:	US
Telephone Number	:	414-266-2873
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2025
Last Update Date	:	01/09/2026

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Practice Location Address:

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1568466928 — MRS. DEBORAH COSTAKOS M.D.
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Practice Location Address:

9000 W WISCONSIN AVE
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1366435265 — JANETTE F STRASBURGER MD
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1376537142 — DR. ROSELLEN S. CHOI M.D.
Practice Location Address:

9000 W WISCONSIN AVE , DEPARTMENT OF PEDIATRICS
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Directions to “ MELANIE E RUETZ ” Practice Location

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