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NPI Code Detail

MEDICARE: MS. MELISSA N. SHOTKOSKI TUFFORD CRNA

MEDICARE: MS. MELISSA N. SHOTKOSKI TUFFORD CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse Anesthetist100954NE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1861457269
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MELISSA N. SHOTKOSKI TUFFORD CRNA
Provider Business Mailing Address
First Line : PO BOX 980
Second Line :
City : LEXINGTON
State : NE
Zip : 68850-0980
Country : US
Telephone Number : 308-324-5651
Fax Number : 308-324-8359
Provider Business Practice Location Address
First Line : 1201 N ERIE ST
Second Line :
City : LEXINGTON
State : NE
Zip : 68850-1571
Country : US
Telephone Number : 308-324-5651
Fax Number : 308-324-8359
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2006
Last Update Date : 04/18/2023

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