Healthcare Provider Details

I. General information

NPI: 1215863675
Provider Name (Legal Business Name): MICHELLE CHRISTINE WESTERBECK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELLE CHRISTINE GRADDY

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 E 27TH ST
KEARNEY NE
68847-4705
US

IV. Provider business mailing address

1400 E 27TH ST
KEARNEY NE
68847-4705
US

V. Phone/Fax

Practice location:
  • Phone: 308-234-2558
  • Fax: 308-237-9341
Mailing address:
  • Phone: 308-234-2558
  • Fax: 308-237-9341

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: