Healthcare Provider Details
I. General information
NPI: 1689179921
Provider Name (Legal Business Name): CAMIE L NITZEL, PHD LP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/28/2018
Last Update Date: 02/12/2020
Certification Date: 02/12/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8001 S 15TH STE C
LINCOLN NE
68512-5963
US
IV. Provider business mailing address
8001 S 15TH STE C
LINCOLN NE
68512
US
V. Phone/Fax
- Phone: 402-483-7900
- Fax: 402-483-7971
- Phone: 402-483-7900
- Fax: 402-483-7971
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | 956 |
| License Number State | NE |
VIII. Authorized Official
Name: DR.
CAMIE
LYNN
NITZEL
Title or Position: PSYCHOLOGIST/OWNER
Credential: PHD LP
Phone: 402-483-7900