Provider Demographics
NPI:1194523274
Name:HAASE, MICHELLE L
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:L
Last Name:HAASE
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 1:617 14TH ST
Mailing Address - Street 2:
Mailing Address - City:WISNER
Mailing Address - State:NE
Mailing Address - Zip Code:68791-2042
Mailing Address - Country:US
Mailing Address - Phone:402-380-1675
Mailing Address - Fax:
Practice Address - Street 1:617 14TH ST
Practice Address - Street 2:
Practice Address - City:WISNER
Practice Address - State:NE
Practice Address - Zip Code:68791-2042
Practice Address - Country:US
Practice Address - Phone:402-380-1675
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-05
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No372500000XNursing Service Related ProvidersChore Provider
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant