Provider Demographics
NPI:1487832218
Name:BROWN, MELISSA MARIE BURNETT (DC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:MARIE BURNETT
Last Name:BROWN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7053 STARLITE DR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68152-2021
Mailing Address - Country:US
Mailing Address - Phone:612-839-4124
Mailing Address - Fax:
Practice Address - Street 1:625 N 114TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-1514
Practice Address - Country:US
Practice Address - Phone:402-523-2761
Practice Address - Fax:402-284-5144
Is Sole Proprietor?:No
Enumeration Date:2008-02-04
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4677111N00000X
NE1781111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor