| Doctor Name: | MELISSA JOHNSON KRISCUNAS |
| NPI Number: | 1578735262 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DO |
| License Number: | 54948 |
| Business Practice Address: | 1430 Highway 96 E White Bear Lake, MN - 551103653 |
| Business Phone Number: | 6516532100 |
| Business Fax Number: | 6516532125 |
| Mailing Address: | Po Box 1309, 8170 33rd Ave S - Mail Stop 21110q MINNEAPOLIS |
| State: | MN |
| Postal Code: | 554254516 |
| Phone Number: | 6516532100 |
| Fax Number: | 6516532125 |
| NPI Enumeration Date: | 04/02/2008 |
| NPI Last Update Date: | 08/11/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207V00000X |
| License Number: | 54948 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Obstetrics & Gynecology |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |