Healthcare Provider Details

I. General information

NPI: 1528803178
Provider Name (Legal Business Name): REBECCA REICKS APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2024
Last Update Date: 12/18/2024
Certification Date: 12/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 22800
LINCOLN NE
68542-2800
US

IV. Provider business mailing address

108 W 9TH ST
HICKMAN NE
68372-1406
US

V. Phone/Fax

Practice location:
  • Phone: 402-471-2861
  • Fax:
Mailing address:
  • Phone: 308-390-8606
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number115446
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number115446
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: