Roth, Melinda M

Roth, Melinda M is an sole proprietor health care provider with primary practice located at 3144 Vanzile Rd , Crandon WI 54520-8149. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Roth, Melinda M can be contacted via phone (715) 478-5180.

Contact Information

Primary practice address
3144 Vanzile Rd Crandon WI 54520-8149
Phone: (715) 478-5180
Fax: (715) 478-5904
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 209010719 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 277000959 Illinois

Profile Details

NPI number 1154757045
LBN Legal business name Roth, Melinda M
Credentials PMHNP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 24th, 2013
Last updated Sep 1st, 2022 - about 4 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1154757045 NPPES
Wisconsin Other 783333 PROVIDER STATE LICENSE
Wisconsin MEDICAID 35957000 PROVIDER STATE LICENSE

Popular Providers