Healthcare Provider Details

I. General information

NPI: 1679444012
Provider Name (Legal Business Name): MICHELLE RENEE BUCHTA APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2025
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6041 VILLAGE DR STE 110
LINCOLN NE
68516-5774
US

IV. Provider business mailing address

6041 VILLAGE DR STE 110
LINCOLN NE
68516-5774
US

V. Phone/Fax

Practice location:
  • Phone: 417-299-3645
  • Fax:
Mailing address:
  • Phone: 417-299-3645
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number116106
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: