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Individual

DR. MELISSA SUE HERNANDEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
10060 REGENCY CIR, OMAHA, NE 68114-3732
(402) 354-1580
(402) 354-1409
Mailing address
PO BOX 3755, OMAHA, NE 68103-0755
(402) 354-2100
(402) 354-2155

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
29039
NE
207R00000X
Internal Medicine Physician
6920
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1407293483
IA
05
47068731742
NE
01
6920
TEP NUMBER
NE
Enumeration date
05/30/2013
Last updated
09/26/2016
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