Healthcare Provider Details

I. General information

NPI: 1376347435
Provider Name (Legal Business Name): BREANNA JANETTE STRICKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2025
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13057 W CENTER RD STE 21
OMAHA NE
68144-3723
US

IV. Provider business mailing address

5960 PRAIRIE VIEW RD
WAMEGO KS
66547-9612
US

V. Phone/Fax

Practice location:
  • Phone: 402-261-5158
  • Fax:
Mailing address:
  • Phone: 402-580-9492
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number111430005
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: