Provider Demographics
NPI:1639831555
Name:REICH, MELISSA (RN)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:REICH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 S NADINE ST
Mailing Address - Street 2:
Mailing Address - City:KIMBALL
Mailing Address - State:NE
Mailing Address - Zip Code:69145-1632
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:901 S NADINE ST
Practice Address - Street 2:
Practice Address - City:KIMBALL
Practice Address - State:NE
Practice Address - Zip Code:69145-1632
Practice Address - Country:US
Practice Address - Phone:308-235-4861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-07
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE64726163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool