Provider Demographics
NPI:1033527296
Name:OLTHOFF, MELISSA LEIGH (PA-C)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:LEIGH
Last Name:OLTHOFF
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:LEIGH
Other - Last Name:VERHAAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:200 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:319-678-7329
Mailing Address - Fax:319-467-8105
Practice Address - Street 1:201 S CLINTON ST STE 168
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-4034
Practice Address - Country:US
Practice Address - Phone:319-678-7329
Practice Address - Fax:319-467-8105
Is Sole Proprietor?:No
Enumeration Date:2014-07-31
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085005548363AM0700X
COPA.0007822363AM0700X
IA082107363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical