Individual
BRIAN EDICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2501 CAPEHART RD, OFFUTT AFB, NE 68113-1043
(402) 294-6647
Mailing address
2501 CAPEHART RD, OFFUTT AFB, NE 68113-1043
(024) 294-6647
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1115655
NCCPA
—
Enumeration date
12/10/2013
Last updated
11/05/2019
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