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NPI Code Detail

MEDICARE: MICAH LYNN OMAN

MEDICARE: MICAH LYNN OMAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1315P00000XIntellectual Disabilities Intermediate Care Facility

General Provider Information

NPI Number : 1134926272
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICAH LYNN OMAN
Provider Business Mailing Address
First Line : 7562 UPTON GREY LN
Second Line :
City : LINCOLN
State : NE
Zip : 68516-5694
Country : US
Telephone Number : 402-805-7395
Fax Number :
Provider Business Practice Location Address
First Line : 7562 UPTON GREY LN
Second Line :
City : LINCOLN
State : NE
Zip : 68516-5694
Country : US
Telephone Number : 402-805-7395
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2025
Last Update Date : 02/26/2025

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