Provider Demographics
NPI:1881952943
Name:REICHERT, MELISSA ANN (RN)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
Last Name:REICHERT
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:N89W15830 MAIN ST
Mailing Address - Street 2:APT 2
Mailing Address - City:MENOMONEE FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53051-2966
Mailing Address - Country:US
Mailing Address - Phone:262-573-2026
Mailing Address - Fax:
Practice Address - Street 1:N89W15830 MAIN ST
Practice Address - Street 2:APT 2
Practice Address - City:MENOMONEE FALLS
Practice Address - State:WI
Practice Address - Zip Code:53051-2966
Practice Address - Country:US
Practice Address - Phone:262-573-2026
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-26
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI184283-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse