Healthcare Provider Details

I. General information

NPI: 1366352841
Provider Name (Legal Business Name): MELISSA ANNE BRILL APRN FAMILY NURSE PR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 20TH ST
GOTHENBURG NE
69138-1237
US

IV. Provider business mailing address

910 20TH ST
GOTHENBURG NE
69138-1237
US

V. Phone/Fax

Practice location:
  • Phone: 308-537-3661
  • Fax: 308-537-3074
Mailing address:
  • Phone: 308-537-3661
  • Fax: 308-537-3074

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number117186
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: