MEDICARE: NICOLE L SCHLEISMAN APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	113735	NE
2	363L00000X	Nurse Practitioner	113735	NE

General Provider Information

NPI Number	:	1104593441
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE L SCHLEISMAN APRN

Provider Business Mailing Address
First Line	:	825 S 169TH ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68118-9300
Country	:	US
Telephone Number	:	402-354-3370
Fax Number	:	402-354-5454

Provider Business Practice Location Address
First Line	:	625 E 29TH ST
Second Line	:
City	:	FREMONT
State	:	NE
Zip	:	68025-2322
Country	:	US
Telephone Number	:	402-727-3351
Fax Number	:	402-941-7075

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/25/2021
Last Update Date	:	10/21/2025

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Directions to “ NICOLE L SCHLEISMAN APRN” Practice Location

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