Healthcare Provider Details

I. General information

NPI: 1346104601
Provider Name (Legal Business Name): ALYCIA MARIE ABRAM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 S 84TH ST STE G
LINCOLN NE
68510-2641
US

IV. Provider business mailing address

123 S 84TH ST STE G
LINCOLN NE
68510-2641
US

V. Phone/Fax

Practice location:
  • Phone: 402-417-3247
  • Fax:
Mailing address:
  • Phone: 402-417-3247
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: