Provider Demographics
NPI:1679163919
Name:NEUMILLER, MEGAN LEE
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:LEE
Last Name:NEUMILLER
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 1:1401 W 11TH ST
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901-3755
Mailing Address - Country:US
Mailing Address - Phone:402-984-9693
Mailing Address - Fax:
Practice Address - Street 1:414 N WILLSON ST
Practice Address - Street 2:
Practice Address - City:BLUE HILL
Practice Address - State:NE
Practice Address - Zip Code:68930-3561
Practice Address - Country:US
Practice Address - Phone:402-756-2080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-20
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE224Z00000X
NE1104224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant