Provider Demographics
NPI:1144194382
Name:MIESALOSKI, MELISSA MARGARET (RN)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:MARGARET
Last Name:MIESALOSKI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:MARGARET
Other - Last Name:VIALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:310 6TH AVE W
Mailing Address - Street 2:
Mailing Address - City:RAY
Mailing Address - State:ND
Mailing Address - Zip Code:58849-4963
Mailing Address - Country:US
Mailing Address - Phone:701-641-6875
Mailing Address - Fax:
Practice Address - Street 1:310 6TH AVE W
Practice Address - Street 2:
Practice Address - City:RAY
Practice Address - State:ND
Practice Address - Zip Code:58849-4963
Practice Address - Country:US
Practice Address - Phone:701-641-6875
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-01
Last Update Date:2025-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND202891163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse