MEDICARE: DR. MICHELLE LYNN UMBARGER-MACKEY PHD, ARNP, PMHNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	G158787	IA

General Provider Information

NPI Number	:	1265174023
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHELLE LYNN UMBARGER-MACKEY PHD, ARNP, PMHNP-BC

Provider Business Mailing Address
First Line	:	373 COLLINS RD NE STE 205
Second Line	:
City	:	CEDAR RAPIDS
State	:	IA
Zip	:	52402-3167
Country	:	US
Telephone Number	:	319-320-7506
Fax Number	:	319-320-7506

Provider Business Practice Location Address
First Line	:	373 COLLINS RD NE STE 205
Second Line	:
City	:	CEDAR RAPIDS
State	:	IA
Zip	:	52402-3167
Country	:	US
Telephone Number	:	319-320-7506
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2022
Last Update Date	:	05/19/2025

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