Provider Demographics
NPI:1619738085
Name:CHOI, MELISSA JOY (RN)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:JOY
Last Name:CHOI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 LINDA LN
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:WI
Mailing Address - Zip Code:54656-2476
Mailing Address - Country:US
Mailing Address - Phone:608-633-2512
Mailing Address - Fax:
Practice Address - Street 1:W4356 CERESA DR
Practice Address - Street 2:
Practice Address - City:WEST SALEM
Practice Address - State:WI
Practice Address - Zip Code:54669-9557
Practice Address - Country:US
Practice Address - Phone:608-633-8072
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI173040163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health