Provider Demographics
NPI:1093516536
Name:POWERS, MELISSA (RN)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:POWERS
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12856 DEAUVILLE DR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68137-3204
Mailing Address - Country:US
Mailing Address - Phone:402-399-1700
Mailing Address - Fax:402-393-0883
Practice Address - Street 1:12875 DEAUVILLE DR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-3242
Practice Address - Country:US
Practice Address - Phone:402-399-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-21
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDR054549163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health