Healthcare Provider Details

I. General information

NPI: 1760391353
Provider Name (Legal Business Name): CAITLYN NICOLE MICEK DNP, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1410 N 13TH ST
NORFOLK NE
68701-2669
US

IV. Provider business mailing address

13991 V RD
SHELBY NE
68662-5535
US

V. Phone/Fax

Practice location:
  • Phone: 402-379-2322
  • Fax:
Mailing address:
  • Phone: 402-909-3128
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number117200
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: