Individual
NICOLE M HAVEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
600 W 12TH ST, IMPERIAL, NE 69033
(308) 882-7299
(308) 882-7341
Mailing address
600 W 12TH ST, IMPERIAL, NE 69033-3131
(308) 882-7299
(308) 882-7341
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1224
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
249920
MIDLANDS CHOICE/MUT OMA
—
01
—
38608
BCBS
NE
Enumeration date
05/12/2006
Last updated
09/10/2018
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