Healthcare Provider Details

I. General information

NPI: 1285448019
Provider Name (Legal Business Name): MELISSA KAY VAHRENKAMP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2025
Last Update Date: 02/03/2025
Certification Date: 02/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5789 HIGHWAY 20
CHADRON NE
69337-7349
US

IV. Provider business mailing address

1142 W 16TH ST
CHADRON NE
69337-9353
US

V. Phone/Fax

Practice location:
  • Phone: 308-432-4050
  • Fax:
Mailing address:
  • Phone: 308-430-2314
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: