Healthcare Provider Details

I. General information

NPI: 1952488678
Provider Name (Legal Business Name): JULIE M MAIKRANZ LMPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4501 S 70TH ST SUITE 120
LINCOLN NE
68516-4276
US

IV. Provider business mailing address

4501 S 70TH ST SUITE 120
LINCOLN NE
68516-4276
US

V. Phone/Fax

Practice location:
  • Phone: 402-483-1936
  • Fax: 402-483-7314
Mailing address:
  • Phone: 402-483-1936
  • Fax: 402-483-7314

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number2811
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: