Healthcare Provider Details

I. General information

NPI: 1053110478
Provider Name (Legal Business Name): MELISSA SCHRAEDER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2025
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

704 S 75TH ST
OMAHA NE
68114-4621
US

IV. Provider business mailing address

3619 GILES RD
BELLEVUE NE
68147-1807
US

V. Phone/Fax

Practice location:
  • Phone: 402-319-4255
  • Fax:
Mailing address:
  • Phone: 402-319-4255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: