Provider Demographics
NPI:1982642765
Name:DAHIR, MELISSA A (APRN)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:A
Last Name:DAHIR
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 N 51ST ST STE 200
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68132-2867
Mailing Address - Country:US
Mailing Address - Phone:402-932-8020
Mailing Address - Fax:402-905-3042
Practice Address - Street 1:119 N 51ST ST STE 200
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68132-2867
Practice Address - Country:US
Practice Address - Phone:402-932-8020
Practice Address - Fax:402-905-3042
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE110730363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47070734613Medicaid
NE47070734613Medicaid