Individual
NICOLE LYNN WAGNER DIX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
700 E 29TH ST, FREMONT, NE 68025-2384
(402) 721-3133
(402) 941-7017
Mailing address
825 S 169TH ST FL 3, OMAHA, NE 68118-9300
(402) 354-4822
(402) 941-7017
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
466
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
466
MEDICAL LICENSE
NE
Enumeration date
05/25/2006
Last updated
06/08/2023
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