Provider Demographics
NPI:1598217184
Name:SWANSON, MELISSA (APNP)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:SWANSON
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:J
Other - Last Name:MCCORD-SCHEFFLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APNP
Mailing Address - Street 1:1300 S CENTURY AVE
Mailing Address - Street 2:
Mailing Address - City:WAUNAKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53597-2386
Mailing Address - Country:US
Mailing Address - Phone:608-849-4315
Mailing Address - Fax:608-850-1606
Practice Address - Street 1:1300 S CENTURY AVE
Practice Address - Street 2:
Practice Address - City:WAUNAKEE
Practice Address - State:WI
Practice Address - Zip Code:53597-2386
Practice Address - Country:US
Practice Address - Phone:608-849-4315
Practice Address - Fax:608-850-1606
Is Sole Proprietor?:No
Enumeration Date:2016-10-29
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8876-33363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1598217184Medicaid