Healthcare Provider Details

I. General information

NPI: 1093516536
Provider Name (Legal Business Name): MELISSA POWERS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2025
Last Update Date: 03/21/2025
Certification Date: 03/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12875 DEAUVILLE DR
OMAHA NE
68137-3242
US

IV. Provider business mailing address

12856 DEAUVILLE DR
OMAHA NE
68137-3204
US

V. Phone/Fax

Practice location:
  • Phone: 402-399-1700
  • Fax:
Mailing address:
  • Phone: 402-399-1700
  • Fax: 402-393-0883

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberR054549
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: