Healthcare Provider Details

I. General information

NPI: 1932871845
Provider Name (Legal Business Name): CHELSEA WICKARD APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2021
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3510 VILLAGE DR
LINCOLN NE
68516-5362
US

IV. Provider business mailing address

3130 NW 49TH ST
LINCOLN NE
68524-1403
US

V. Phone/Fax

Practice location:
  • Phone: 402-937-1920
  • Fax: 402-937-1195
Mailing address:
  • Phone: 308-225-1102
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number113839
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: