Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 111783 | NE |
NPI | 1023404829 |
---|---|
Provider Name | Michelle Christo |
First Address | Omaha, NE 68137-1133 |
Second Address | Omaha, NE 68137-1133 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2015 |
Last Update Date | 22/08/2019 |