Healthcare Provider Details

I. General information

NPI: 1386530269
Provider Name (Legal Business Name): NANCY JEAN KOZOL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2025
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 WICKLOW RD
PAPILLION NE
68046-7053
US

IV. Provider business mailing address

1101 WICKLOW RD
PAPILLION NE
68046-7053
US

V. Phone/Fax

Practice location:
  • Phone: 402-490-4913
  • Fax:
Mailing address:
  • Phone: 402-490-4913
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number385HR2055X
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: