Healthcare Provider Details

I. General information

NPI: 1548822257
Provider Name (Legal Business Name): MELISSA M HOHENSTEIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2019
Last Update Date: 10/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7710 MERCY RD STE 1000
OMAHA NE
68124-2323
US

IV. Provider business mailing address

7710 MERCY RD STE 1000
OMAHA NE
68124-2323
US

V. Phone/Fax

Practice location:
  • Phone: 402-717-3600
  • Fax: 402-343-8891
Mailing address:
  • Phone: 402-717-3600
  • Fax: 402-343-8891

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberH155783
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number112844
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: