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General NPI Number Information
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NPI Number | 1669021796
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Entity Type | Individual
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Provider Name | MELISSA PRICKETT APRN
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Gender | Female
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Dates
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Enumeration Date | 09/11/2019
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Last Update Date | 11/10/2025
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Provider Practice Location Address
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Address Line | 2126 N 117TH AVE
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City | OMAHA
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State | NE
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Zip | 68164-3670
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Country | US
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Telephone | 402-934-1617
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Fax | 402-934-5228
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Provider Business Mailing Address
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Address Line | 4608 N 188TH ST
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City | ELKHORN
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State | NE
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Zip | 68022-1243
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Country | US
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Telephone | 402-304-9069
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 112952
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License Number State | NE
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