Individual
DR. MELINDA KATHRYN KENNEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1130 S 13TH ST STE 200, NORFOLK, NE 68701-5733
(402) 379-1434
(402) 374-9154
Mailing address
1130 S 13TH ST STE 200, NORFOLK, NE 68701-5733
(402) 379-1434
(402) 371-9154
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1190
NE
152W00000X
Optometrist
1728
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200383330A
—
KS
05
—
200383330B
—
KS
01
—
36700
BCBS
NE
01
—
651109
BCBS
KS
01
—
651110
BCBS
KS
01
—
NA1061002
MEDICARE PTAN
NE
05
—
SSN00
—
NE
Enumeration date
11/02/2005
Last updated
10/26/2021
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