Provider Demographics
NPI:1376072553
Name:CZAPKA, MELISSA RENE (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:RENE
Last Name:CZAPKA
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 S 4TH ST
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:WA
Mailing Address - Zip Code:99328-1405
Mailing Address - Country:US
Mailing Address - Phone:509-386-4259
Mailing Address - Fax:
Practice Address - Street 1:1012 S 3RD ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:WA
Practice Address - Zip Code:99328-1606
Practice Address - Country:US
Practice Address - Phone:509-382-2531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-09
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60757409363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner