Provider Demographics
NPI:1720176142
Name:MESSER, MELISSA A (PA-C)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:A
Last Name:MESSER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 COMPASSION WAY
Mailing Address - Street 2:
Mailing Address - City:DODGEVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53533-1956
Mailing Address - Country:US
Mailing Address - Phone:608-930-7200
Mailing Address - Fax:
Practice Address - Street 1:800 COMPASSION WAY
Practice Address - Street 2:
Practice Address - City:DODGEVILLE
Practice Address - State:WI
Practice Address - Zip Code:53533-1956
Practice Address - Country:US
Practice Address - Phone:608-930-7187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2054-23363A00000X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI61108OtherDEAN HEALTH INSURANCE
WI61108OtherDEAN HEALTH INSURANCE
WI741501899Medicare PIN