Healthcare Provider Details

I. General information

NPI: 1124969324
Provider Name (Legal Business Name): MRS. MAKAYLAH MORTON SALMON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2026
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5618 N 14TH AVE
OMAHA NE
68110-1134
US

IV. Provider business mailing address

28 FAIRCHILD CIR
OFFUTT AFB NE
68113-1010
US

V. Phone/Fax

Practice location:
  • Phone: 531-299-5048
  • Fax:
Mailing address:
  • Phone: 443-882-3426
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number14699
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: