Provider Demographics
NPI:1366734188
Name:KRAUSE, MELINDA SUE (OTR/L)
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:SUE
Last Name:KRAUSE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2202 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68005-5257
Mailing Address - Country:US
Mailing Address - Phone:402-293-4941
Mailing Address - Fax:402-293-4351
Practice Address - Street 1:8031 W CENTER RD
Practice Address - Street 2:SUITE #300
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-3158
Practice Address - Country:US
Practice Address - Phone:402-391-5002
Practice Address - Fax:402-343-1278
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-12
Last Update Date:2013-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE443225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist