Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 30556 | WI |
NPI | 1023154903 |
---|---|
Provider Name | Melissa L Earnest |
First Address | Menomonee Falls, WI 53051-4049 |
Second Address | Menomonee Falls, WI 53051-4049 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2007 |
Last Update Date | 15/09/2010 |