Healthcare Provider Details

I. General information

NPI: 1881527679
Provider Name (Legal Business Name): MICHELLE L KENNEDY CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELLE L MESSBARGER

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 E 31ST ST
KEARNEY NE
68847-2926
US

IV. Provider business mailing address

PO BOX 1771
KEARNEY NE
68848-1771
US

V. Phone/Fax

Practice location:
  • Phone: 308-865-7100
  • Fax:
Mailing address:
  • Phone: 308-236-5506
  • Fax: 308-236-7089

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number102004
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: