Individual
DR. KATHY L. HAVLICEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, APRN-NP
Contact information
Practice address
7111 A ST STE 201, LINCOLN, NE 68510-4283
(402) 489-7100
(402) 489-3249
Mailing address
6831 SUMNER ST, LINCOLN, NE 68506-1548
(402) 525-1512
(402) 488-6031
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
110806
NE
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
110806
NE
363LP2300X
Primary Care Nurse Practitioner
110806
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10025595500
MEDICAID PIN
NE
01
—
252878
MIDLANDS - NHCP
NE
01
—
39194
BCBS - NHCP
NE
Enumeration date
08/30/2006
Last updated
05/02/2021
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