Healthcare Provider Details

I. General information

NPI: 1720907041
Provider Name (Legal Business Name): NIKOLA WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2026
Last Update Date: 07/11/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1408 FORT CROOK RD S
BELLEVUE NE
68005-3061
US

IV. Provider business mailing address

6645 S 84TH AVE
OMAHA NE
68127-4104
US

V. Phone/Fax

Practice location:
  • Phone: 402-507-9797
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: