Provider Demographics
NPI:1053120618
Name:MCINTYRE, MICHELLE LEIGH
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LEIGH
Last Name:MCINTYRE
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 1:1116 SYCAMORE AVE
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901-3399
Mailing Address - Country:US
Mailing Address - Phone:402-469-9199
Mailing Address - Fax:402-461-4398
Practice Address - Street 1:1116 SYCAMORE AVE
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-3399
Practice Address - Country:US
Practice Address - Phone:402-469-9199
Practice Address - Fax:402-461-4398
Is Sole Proprietor?:No
Enumeration Date:2025-01-07
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide