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Individual

NICOLE KORICIC

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NURSE PRACTITIONER

Contact information

Practice address
4014 LEAVENWORTH ST, OMAHA, NE 68105-1053
(402) 559-8000
Mailing address
988102 NEBRASKA MEDICAL CTR, OMAHA, NE 68198-8102

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
112157
NE
363LF0000X
Family Nurse Practitioner
112157
NE
363LF0000X
Family Nurse Practitioner
A142416
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
112157
NEBRASKA MEDICAL LICENSE
NE
Enumeration date
02/15/2017
Last updated
10/06/2020
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