Healthcare Provider Details

I. General information

NPI: 1053354944
Provider Name (Legal Business Name): MICHELLE LYNN HINZE D.P.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 08/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2705 SAMSON WAY
BELLEVUE NE
68123-4307
US

IV. Provider business mailing address

2705 SAMSON WAY
BELLEVUE NE
68123-4307
US

V. Phone/Fax

Practice location:
  • Phone: 402-331-6387
  • Fax: 402-331-6537
Mailing address:
  • Phone: 402-331-6387
  • Fax: 402-331-6537

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number306
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number306
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: