Individual
BENJAMIN GROSSNICKLAUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
804 22ND AVE, KEARNEY, NE 68845-2206
(308) 455-3600
Mailing address
816 22ND AVE STE 100, KEARNEY, NE 68845-2226
(308) 865-2263
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
101927
NE
Other
Enumeration date
03/07/2025
Last updated
09/11/2025
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