Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Melinda M Roth, PMHNP

Individual provider Family Nurse Practitioner · NPI 1154757045

Melinda M Roth, PMHNP is a Nurse Practitioner in Crandon, Wisconsin. Qualified in 2016, 10 years ago. Practices with Sokaogon Chippewa Community, a 13-clinician group, works from 3 locations, accepts Medicare assignment and offers telehealth. Licensed in Illinois.

Years since qualifying
10
Licensed in
IL
In the registry since
2013
Specialties on file
2
What do these letters mean?
PMHNP — Psychiatric-Mental Health Nurse Practitioner
A nurse practitioner specialising in mental health, able to prescribe psychiatric medication.

See every abbreviation used in this directory →

Practice location Address checks out

3144 Vanzile Rd
Crandon, WI 54520-8149
Phone: (715) 478-5180
Fax: (715) 478-5904
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 108 W Market St, Bloomington, IL 61701-3918 — (309) 827-5351
  • 1100 Beech St Bldg 10, Normal, IL 61761-1493 — (309) 463-5800

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 277000959 (IL)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 209010719 (IL)

Record details

NPI number1154757045
Entity typeIndividual (Type 1)
GenderFemale
Credentials PMHNP
Sole proprietorYes
NPI enumeratedSeptember 24, 2013
Last updated in NPPESSeptember 1, 2022
Certification dateMarch 30, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Sokaogon Chippewa Community — 13 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Crandon