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NPI Code Detail

MEDICARE: MS. MELISSA L. TOMPKINS PA C

MEDICARE: MS. MELISSA L. TOMPKINS PA C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant960NE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
137857OTHERNEBCBS OF NEBRASKA

General Provider Information

NPI Number : 1811904568
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MELISSA L. TOMPKINS PA C
Provider Business Mailing Address
First Line : PO BOX N
Second Line :
City : SYRACUSE
State : NE
Zip : 68446-0518
Country : US
Telephone Number : 402-269-2011
Fax Number : 402-269-2795
Provider Business Practice Location Address
First Line : 2731 HEALTHCARE DR
Second Line :
City : SYRACUSE
State : NE
Zip : 68446-7880
Country : US
Telephone Number : 402-269-2011
Fax Number : 402-269-3369
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2006
Last Update Date : 03/08/2019

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