Healthcare Provider Details

I. General information

NPI: 1306646294
Provider Name (Legal Business Name): MELISSA LAMB
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2025
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3610 DODGE ST STE 100
OMAHA NE
68131-3218
US

IV. Provider business mailing address

3610 DODGE ST STE 100
OMAHA NE
68131-3218
US

V. Phone/Fax

Practice location:
  • Phone: 531-777-8859
  • Fax:
Mailing address:
  • Phone: 531-777-8859
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: