Healthcare Provider Details

I. General information

NPI: 1649912635
Provider Name (Legal Business Name): NICHOLAS EDWARDS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2022
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

988435 NEBRASKA MEDICAL CTR
OMAHA NE
68198-8435
US

IV. Provider business mailing address

988435 NEBRASKA MEDICAL CTR
OMAHA NE
68198-8435
US

V. Phone/Fax

Practice location:
  • Phone: 402-559-8600
  • Fax: 402-559-9355
Mailing address:
  • Phone: 402-559-8600
  • Fax: 402-559-9355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number37371
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: