Healthcare Provider Details

I. General information

NPI: 1083753693
Provider Name (Legal Business Name): MICHELLE L BATTERMAN PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 10/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2207 OSBORNE DR W SUITE 100
HASTINGS NE
68901-9111
US

IV. Provider business mailing address

2207 OSBORNE DR W SUITE 100
HASTINGS NE
68901-9111
US

V. Phone/Fax

Practice location:
  • Phone: 402-462-2139
  • Fax: 402-462-2381
Mailing address:
  • Phone: 402-462-2139
  • Fax: 402-462-2381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1300
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: