Individual
MIKAYLA MARIE GREENWALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1111 N 102ND CT STE 200, OMAHA, NE 68114-2194
(402) 502-2747
Mailing address
6701 SW 34TH ST, LINCOLN, NE 68523-9133
(402) 937-3296
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
3061
NE
Other
Enumeration date
07/21/2022
Last updated
02/06/2024
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