Healthcare Provider Details
I. General information
NPI: 1720508419
Provider Name (Legal Business Name): MICHELLE LYNN WINEINGER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/22/2017
Last Update Date: 03/22/2024
Certification Date: 03/22/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5625 S 62ND ST STE 100
LINCOLN NE
68516-3558
US
IV. Provider business mailing address
9801 GILES RD STE 1
LA VISTA NE
68128-2925
US
V. Phone/Fax
- Phone: 402-489-3834
- Fax: 402-489-5049
- Phone: 402-955-8400
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 31595 |
| License Number State | NE |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: