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NPI Code Detail

MEDICARE: LAUREN C BRICKETT PA

MEDICARE:   LAUREN C BRICKETT  PA
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
1363AS0400XSurgical Physician Assistant3152NE
2363A00000XPhysician Assistant3152NE

General Provider Information

NPI Number : 1639997778
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAUREN C BRICKETT PA
Provider Business Mailing Address
First Line : 87999 SPUR 26 E
Second Line :
City : PONCA
State : NE
Zip : 68770-7100
Country : US
Telephone Number : 515-227-1245
Fax Number :
Provider Business Practice Location Address
First Line : 8200 DODGE ST
Second Line :
City : OMAHA
State : NE
Zip : 68114-4113
Country : US
Telephone Number : 402-955-5400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2024
Last Update Date : 01/08/2026

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Directions to “ LAUREN C BRICKETT PA” Practice Location

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