Provider Demographics
NPI:1346553898
Name:HUTZLER, MELISSA A (PA)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:A
Last Name:HUTZLER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MS
Other - First Name:MELISSA
Other - Middle Name:A
Other - Last Name:ISENNOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:801 YORK ST
Mailing Address - Street 2:
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54220-4630
Mailing Address - Country:US
Mailing Address - Phone:920-663-7190
Mailing Address - Fax:920-684-1439
Practice Address - Street 1:1000 STONEWOOD DR
Practice Address - Street 2:SUITE 200
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-8386
Practice Address - Country:US
Practice Address - Phone:724-778-3020
Practice Address - Fax:724-778-3024
Is Sole Proprietor?:No
Enumeration Date:2010-07-26
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant