Provider Demographics
NPI:1437854460
Name:KOBZA, MACY LYNN
Entity Type:Individual
Prefix:
First Name:MACY
Middle Name:LYNN
Last Name:KOBZA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 43 1/2 RD
Mailing Address - Street 2:
Mailing Address - City:BELLWOOD
Mailing Address - State:NE
Mailing Address - Zip Code:68624-2441
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:403 LINE DRIVE CIR
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68508-4010
Practice Address - Country:US
Practice Address - Phone:402-472-4224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-31
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer