Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mrs. Mikayla K Grevengoed, PA

Individual provider Physician Assistant · NPI 1215568175

Mrs. Mikayla K Grevengoed, PA is a Physician Assistant in Omaha, Nebraska. Licensed in Iowa and Nebraska. Registered with an NPI since 2020.

Licensed in
IA, NE
In the registry since
2020
Specialties on file
3
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

8200 Dodge St
Omaha, NE 68114
Phone: (402) 955-5400
Fax: (402) 955-4364
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 2429 (NE)
Physician Assistant Taxonomy 363A00000X · Licence 115612 (IA)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 2429 (NE)

Record details

NPI number1215568175
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedJanuary 30, 2020
Last updated in NPPESMay 13, 2023
Certification dateMay 13, 2023

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