Healthcare Provider Details
I. General information
NPI: 1699661793
Provider Name (Legal Business Name): MICHALLA BURMESTER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/16/2025
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1212 WATSON ST
FREMONT NE
68025-2088
US
IV. Provider business mailing address
1212 WATSON ST
FREMONT NE
68025-2088
US
V. Phone/Fax
- Phone: 402-459-2642
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 372500000X |
| Taxonomy | Chore Provider |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3747P1801X |
| Taxonomy | Personal Care Attendant |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: