Healthcare Provider Details

I. General information

NPI: 1518302157
Provider Name (Legal Business Name): BRADY ALLEN FICKENSCHER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2013
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2114 N LINCOLN AVE STE A
YORK NE
68467-1072
US

IV. Provider business mailing address

2222 N LINCOLN AVE
YORK NE
68467-1030
US

V. Phone/Fax

Practice location:
  • Phone: 402-362-5555
  • Fax: 402-559-6501
Mailing address:
  • Phone: 402-362-0615
  • Fax: 402-362-6328

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number6911
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: