NPI 1154757045

Melinda M Roth, PMHNP

Practitioner Psychiatric/Mental Health Nurse Practitioner Crandon, WI

Practice location

Address: 3144 Vanzile Rd, Crandon, WI 54520-8149
Phone: (715) 478-5180
Fax: (715) 478-5904
Mailing address: 1100 Beech St Bldg 10, Normal, IL 61761-1493

Registered specialties (2)

Psychiatric/Mental Health Nurse Practitioner Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363LP0808X Licence 277000959 (IL)

Other Nurse Practitioner providers in Wisconsin →

Family Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363LF0000X Licence 209010719 (IL)

Registry record

NPI: 1154757045
Entity type: Individual
Sex (as registered): Female
NPI issued: 24 Sep 2013
Record last updated: 1 Sep 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.