Provider Demographics
NPI:1770954869
Name:NOSBISCH, MICHELE R (OTR/L)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:R
Last Name:NOSBISCH
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20601 GLENN ST
Mailing Address - Street 2:
Mailing Address - City:ELKHORN
Mailing Address - State:NE
Mailing Address - Zip Code:68022-2325
Mailing Address - Country:US
Mailing Address - Phone:402-289-2579
Mailing Address - Fax:
Practice Address - Street 1:20601 GLENN ST
Practice Address - Street 2:
Practice Address - City:ELKHORN
Practice Address - State:NE
Practice Address - Zip Code:68022-2325
Practice Address - Country:US
Practice Address - Phone:402-289-2579
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-14
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE478225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics