Koebernick, Michael L

Koebernick, Michael L is an individual health care provider with primary practice located at 575 S 70Th St #400, Lincoln NE 68510-2471. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Koebernick, Michael L can be contacted via phone (402) 488-3002.

Contact Information

Primary practice address
575 S 70Th St #400 Lincoln NE 68510-2471
Phone: (402) 488-3002
Fax: (402) 483-8787
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 937 Nebraska

Profile Details

NPI number 1053396457
LBN Legal business name Koebernick, Michael L
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 8th, 2005
Last updated Dec 14th, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053396457 NPPES
Nebraska MEDICAID 47061995513

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