MEDICARE: MISS MELISSA G FORRETT RN

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	163WS0200X	School Registered Nurse	241943-30	WI

General Provider Information

NPI Number	:	1629309752
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS MELISSA G FORRETT RN

Provider Business Mailing Address
First Line	:	907 ROGERS ST
Second Line	:
City	:	MILTON
State	:	WI
Zip	:	53563-1755
Country	:	US
Telephone Number	:	608-449-8819
Fax Number	:

Provider Business Practice Location Address
First Line	:	825 W MADISON AVE
Second Line	:
City	:	MILTON
State	:	WI
Zip	:	53563-1035
Country	:	US
Telephone Number	:	608-868-9246
Fax Number	:

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

Provider Enumeration Date	:	01/29/2010
Last Update Date	:	04/27/2026

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