Provider Demographics
NPI:1639645799
Name:SCHIFFERN, MICHELLE HOLCOMB (LPN)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:HOLCOMB
Last Name:SCHIFFERN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FRIEND
Mailing Address - State:NE
Mailing Address - Zip Code:68359-1349
Mailing Address - Country:US
Mailing Address - Phone:402-947-2781
Mailing Address - Fax:
Practice Address - Street 1:501 S MAIN ST
Practice Address - Street 2:
Practice Address - City:FRIEND
Practice Address - State:NE
Practice Address - Zip Code:68359-1349
Practice Address - Country:US
Practice Address - Phone:402-947-2781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-16
Last Update Date:2018-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE13393164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse