Provider Demographics
NPI:1245201896
Name:DURR, MICHELE L (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:L
Last Name:DURR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 665
Mailing Address - Street 2:
Mailing Address - City:ALMA
Mailing Address - State:NE
Mailing Address - Zip Code:68920-0665
Mailing Address - Country:US
Mailing Address - Phone:308-928-2103
Mailing Address - Fax:308-928-2560
Practice Address - Street 1:715 BROWN ST
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:NE
Practice Address - Zip Code:68920-2132
Practice Address - Country:US
Practice Address - Phone:308-928-2103
Practice Address - Fax:308-928-2560
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE23074207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEI48057Medicare UPIN
NE279691Medicare ID - Type Unspecified