Healthcare Provider Details

I. General information

NPI: 1124945084
Provider Name (Legal Business Name): COURTNEY MICHELS
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4004 PIONEER WOODS DR
LINCOLN NE
68506-7548
US

IV. Provider business mailing address

1736 OAKDALE AVE
LINCOLN NE
68506-1826
US

V. Phone/Fax

Practice location:
  • Phone: 402-484-4900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License Number74453
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: