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General NPI Number Information
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NPI Number | 1366770489
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Entity Type | Individual
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Provider Name | MELISSA RUTH HYNEK APRN
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Gender | Female
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Dates
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Enumeration Date | 12/01/2009
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Last Update Date | 07/02/2019
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Provider Practice Location Address
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Address Line | 201 RIDGE ST STE 312
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City | COUNCIL BLUFFS
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State | IA
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Zip | 51503-4643
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Country | US
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Telephone | 712-396-7880
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Fax | 712-396-7885
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Provider Business Mailing Address
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Address Line | PO BOX 3755
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City | OMAHA
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State | NE
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Zip | 68103-0755
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Country | US
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Telephone | 402-354-2100
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Fax | 402-354-5451
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 111083
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | F-123448
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License Number State | IA
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | F123448
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License Number State | IA
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