Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NI0013X | Independent Medical Examiner | 1975 | NE |
NPI | 1023501004 |
---|---|
Provider Name | Lee Ann Michel |
First Address | Lincoln, NE 68506-4337 |
Second Address | Lincoln, NE 68506-7569 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2018 |
Last Update Date | 03/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1975 | STATE LICENSE (01) | NE |