Provider Demographics
NPI:1386036655
Name:WACHHOLZ, MELISSA MARIE (PA-C)
Entity Type:Individual
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First Name:MELISSA
Middle Name:MARIE
Last Name:WACHHOLZ
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Gender:F
Credentials:PA-C
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Other - Credentials:
Mailing Address - Street 1:701 PARK AVE
Mailing Address - Street 2:ORANGE BUILDING, O5.210
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55415-1623
Mailing Address - Country:US
Mailing Address - Phone:612-873-3000
Mailing Address - Fax:
Practice Address - Street 1:701 PARK AVE
Practice Address - Street 2:ORANGE BUILDING, O5.210
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55415-1623
Practice Address - Country:US
Practice Address - Phone:612-873-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-24
Last Update Date:2023-03-14
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical