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General NPI Number Information
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NPI Number | 1518302157
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Entity Type | Individual
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Provider Name | BRADY ALLEN FICKENSCHER M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/09/2013
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 2114 N LINCOLN AVE STE A
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City | YORK
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State | NE
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Zip | 68467-1072
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Country | US
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Telephone | 402-362-5555
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Fax | 402-559-6501
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Provider Business Mailing Address
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Address Line | 2222 N LINCOLN AVE
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City | YORK
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State | NE
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Zip | 68467-1030
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Country | US
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Telephone | 402-362-0615
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Fax | 402-362-6328
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 6911
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License Number State | NE
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