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General NPI Number Information
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NPI Number | 1518196369
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Entity Type | Individual
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Provider Name | NICOLE LYNN HENN PA-C
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Gender | Female
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Dates
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Enumeration Date | 07/14/2009
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Last Update Date | 03/24/2021
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Provider Practice Location Address
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Address Line | 2222 S 16TH ST STE 240
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City | LINCOLN
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State | NE
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Zip | 68502-3764
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Country | US
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Telephone | 402-323-7260
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Fax | 402-323-7266
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Provider Business Mailing Address
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Address Line | PO BOX 209
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City | NORFOLK
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State | NE
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Zip | 68702-0209
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Country | US
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Telephone | 402-379-2322
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Fax | 402-379-9533
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 1454
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License Number State | NE
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