Provider Demographics
NPI:1457430357
Name:MUHS, MELISSA L (PAC)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:L
Last Name:MUHS
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:MISS
Other - First Name:MELISSA
Other - Middle Name:L
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PAC
Mailing Address - Street 1:8248 S 96TH ST
Mailing Address - Street 2:
Mailing Address - City:LA VISTA
Mailing Address - State:NE
Mailing Address - Zip Code:68128-3126
Mailing Address - Country:US
Mailing Address - Phone:402-717-9500
Mailing Address - Fax:402-717-9501
Practice Address - Street 1:8248 S 96TH ST
Practice Address - Street 2:
Practice Address - City:LA VISTA
Practice Address - State:NE
Practice Address - Zip Code:68128-3126
Practice Address - Country:US
Practice Address - Phone:402-717-9500
Practice Address - Fax:402-717-9501
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1509363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE38996OtherBCBS OF NEBRASKA
NE970030331OtherRAILROAD MEDICARE
NEP822646Medicare UPIN
NE38996OtherBCBS OF NEBRASKA