Healthcare Provider Details

I. General information

NPI: 1629459318
Provider Name (Legal Business Name): NICOLE MARIE TIMM M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2015
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11446 VALLEY RIDGE DR STE 117
PAPILLION NE
68046-6271
US

IV. Provider business mailing address

11446 VALLEY RIDGE DR STE 117
PAPILLION NE
68046-6271
US

V. Phone/Fax

Practice location:
  • Phone: 402-916-4539
  • Fax:
Mailing address:
  • Phone: 402-916-4539
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number5645
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-17-27146
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: