Provider Demographics
NPI:1518684737
Name:BERNAL, MICHALA MARIE
Entity Type:Individual
Prefix:
First Name:MICHALA
Middle Name:MARIE
Last Name:BERNAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MICHALA
Other - Middle Name:MARIE
Other - Last Name:STEPANEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9802 NICHOLAS ST STE 395
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-2168
Mailing Address - Country:US
Mailing Address - Phone:732-806-0091
Mailing Address - Fax:
Practice Address - Street 1:5905 O ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-2235
Practice Address - Country:US
Practice Address - Phone:402-436-1905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-27
Last Update Date:2023-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider