MEDICARE: KAYLA M DICKE P.A.-C.

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	207Y00000X	Otolaryngology Physician	1377	NE
2	363AS0400X	Surgical Physician Assistant	1377	NE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	37454	OTHER	NE	BLUE CROSS OF NEBRASKA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	061181648-68601-A004	OTHER	NE	TRIWEST
5	255449	OTHER	NE	MIDLANDS CHOICE PPO

General Provider Information

NPI Number	:	1801064878
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLA M DICKE P.A.-C.

Provider Business Mailing Address
First Line	:	PO BOX 1800
Second Line	:
City	:	COLUMBUS
State	:	NE
Zip	:	68602-1800
Country	:	US
Telephone Number	:	402-563-4500
Fax Number	:	402-562-3378

Provider Business Practice Location Address
First Line	:	4508 38TH ST
Second Line	:	SUITE #152
City	:	COLUMBUS
State	:	NE
Zip	:	68601-1668
Country	:	US
Telephone Number	:	402-563-4500
Fax Number	:	402-563-3520

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

Provider Enumeration Date	:	02/13/2008
Last Update Date	:	01/28/2026

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Directions to “ KAYLA M DICKE P.A.-C.” Practice Location

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