Healthcare Provider Details

I. General information

NPI: 1710129358
Provider Name (Legal Business Name): MELISSA A MOSEL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MELISSA A ZIMMERMAN M.D.

II. Dates (important events)

Enumeration Date: 03/27/2009
Last Update Date: 06/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 WEST FRANCIS ST SUITE 200
NORTH PLATTE NE
69101-0614
US

IV. Provider business mailing address

611 WEST FRANCIS ST SUITE 200
NORTH PLATTE NE
69101-0614
US

V. Phone/Fax

Practice location:
  • Phone: 308-534-9230
  • Fax: 308-534-5016
Mailing address:
  • Phone: 308-534-9230
  • Fax: 308-534-5016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number27076
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: