Organization
OMAHA NEUROLOGICAL CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICOLE M LIEBENTRITT M.D. (PRESIDENT)
(402) 393-2023
Entity
Organization
Contact information
Practice address
10020 NICHOLAS STREET, SUITE 202, OMAHA, NE 68114
(402) 393-2023
(402) 393-3244
Mailing address
10020 NICHOLAS STREET, SUITE 202, OMAHA, NE 68114-2188
(402) 393-2023
(402) 393-3244
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01907
BCBS OF NE
NE
05
—
0938977
—
IA
01
—
C02009
RAILROAD MEDICARE
NE
Enumeration date
09/06/2006
Last updated
07/21/2022
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