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Melinda M Roth, PMHNP
Psychiatric/Mental Health Nurse Practitioner in Crandon, Wisconsin
NPI 1154757045

Melinda M Roth is a Psychiatric/Mental Health Nurse Practitioner based in Normal, WI and is specialized in Psychiatric/Mental Health. Melinda M Roth practices in Crandon, WI and has the professional credentials of PMHNP. The NPI Number for Melinda M Roth is 1154757045 and holds a License No. 209010719 (Wisconsin).

The current practice location address for Melinda M Roth is 3144 Vanzile Rd, Crandon, WI and can be reached out via phone at 715-478-5180 and via fax at 715-478-5904.

Location: 3144 Vanzile Rd, Crandon, WI, 61761-1493
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Provider Profile Details
NPI Number
1154757045
Provider Name
Melinda M Roth
Credential
PMHNP
Provider Entity Type
Individual
Gender
Female
Address
3144 Vanzile Rd, Crandon, WI, 61761-1493
Phone Number
715-478-5180
Fax Number
715-478-5904
Provider Enumeration Date
09/24/2013
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
783333 01 WI PROVIDER STATE LICENSE
35957000 05 WI
institution
Provider Business Practice Location Address Details
Address
3144 Vanzile Rd
City
State
Zip
54520-8149
Phone Number
715-478-5180
Fax Number
715-478-5904
person
Provider Business Mailing Address Details
Address
3144 Vanzile Rd
City
State
Zip
54520-8149
Phone Number
715-478-5180
Fax Number
715-478-5904
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
277000959 (Illinois)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Psychiatric/Mental Health
Taxonomy
License No.
209010719 (Illinois)
Definition
Definition to come...
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