Healthcare Provider Details

I. General information

NPI: 1487466868
Provider Name (Legal Business Name): LEAH MARIE FICKBOHM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2025
Last Update Date: 01/23/2025
Certification Date: 01/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2767 PARK PLACE DR
FREMONT NE
68025-3790
US

IV. Provider business mailing address

426 E 22ND ST
FREMONT NE
68025-2609
US

V. Phone/Fax

Practice location:
  • Phone: 402-720-5824
  • Fax:
Mailing address:
  • Phone: 402-720-5824
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: