Healthcare Provider Details

I. General information

NPI: 1306655451
Provider Name (Legal Business Name): MONICA SUE NEDICH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2025
Last Update Date: 01/03/2025
Certification Date: 01/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9801 W CENTER RD
OMAHA NE
68124-1936
US

IV. Provider business mailing address

3109 PEDERSEN DR
OMAHA NE
68144-3912
US

V. Phone/Fax

Practice location:
  • Phone: 402-390-6460
  • Fax:
Mailing address:
  • Phone: 402-390-6460
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: