Provider Demographics
NPI:1790654036
Name:AUSTIN, MICHELLE QUINN
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:QUINN
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5421 N 103RD ST STE 401
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68134-1010
Mailing Address - Country:US
Mailing Address - Phone:402-393-2525
Mailing Address - Fax:402-393-2441
Practice Address - Street 1:5421 N 103RD ST STE 401
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68134-1010
Practice Address - Country:US
Practice Address - Phone:402-393-2525
Practice Address - Fax:402-393-2441
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-04
Last Update Date:2025-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide