Healthcare Provider Details

I. General information

NPI: 1841723483
Provider Name (Legal Business Name): SHEILA KROLIKOWSKI LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2017
Last Update Date: 04/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2846 OLD FAIR RD
GRAND ISLAND NE
68803-5222
US

IV. Provider business mailing address

4980 S 118TH ST
OMAHA NE
68137-2200
US

V. Phone/Fax

Practice location:
  • Phone: 308-381-1690
  • Fax: 308-381-6520
Mailing address:
  • Phone: 402-896-3884
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number13404
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: