Provider Demographics
NPI:1477350593
Name:GENZ, MICHAELA ELIZABETH
Entity type:Individual
Prefix:
First Name:MICHAELA
Middle Name:ELIZABETH
Last Name:GENZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3445 N 106TH PLZ APT 1709
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68134-3656
Mailing Address - Country:US
Mailing Address - Phone:712-435-0659
Mailing Address - Fax:
Practice Address - Street 1:11340 BLONDO ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68164-3815
Practice Address - Country:US
Practice Address - Phone:402-444-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE107323373H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist