Provider Demographics
NPI:1104639723
Name:URBANOVSKY, MAKAELA RAE
Entity type:Individual
Prefix:
First Name:MAKAELA
Middle Name:RAE
Last Name:URBANOVSKY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MAKAELA
Other - Middle Name:RAE
Other - Last Name:OLTMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7562 UPTON GREY LN
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-5694
Mailing Address - Country:US
Mailing Address - Phone:402-890-6550
Mailing Address - Fax:402-325-1619
Practice Address - Street 1:7562 UPTON GREY LN
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-5694
Practice Address - Country:US
Practice Address - Phone:402-890-6550
Practice Address - Fax:402-325-1619
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-28
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health