Dercks, Melissa A
Dercks, Melissa A is an individual health care provider with primary practice located at 725 S Webster Ave Suite 201, Green Bay WI 54301-3500. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Dercks, Melissa A can be contacted via phone (920) 430-7100.Contact Information
Primary practice address
725 S Webster Ave Suite 201
Green Bay WI 54301-3500
Phone: (920) 430-7100
Fax: (920) 430-7114
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Adult Health | 363LA2200X | 4010-33 | Wisconsin |
Profile Details
| NPI number | 1710202577 |
|---|---|
| LBN Legal business name | Dercks, Melissa A |
| Credentials | APNP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 5th, 2010 |
| Last updated | Jul 14th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710202577 | NPPES |
| Other | 2010002130 | AMERICAN NURSES CREDENTIALING CENTER | |
| Other | 4010-33 | AMERICAN NURSES CREDENTIALING CENTER |
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