Individual
NICOLE KRATOCHVIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
812 N 22ND ST, BLAIR, NE 68008-1128
(402) 426-4611
(402) 426-4642
Mailing address
812 N 22ND ST, BLAIR, NE 68008-1128
(402) 426-4611
(402) 426-4642
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2099
NE
363AM0700X
Medical Physician Assistant
2099
NE
363AM0700X
Medical Physician Assistant
4901
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2099
NE STATE LICENSE
NE
01
—
4901
AZ STATE PA LICENSE
AZ
Enumeration date
07/19/2011
Last updated
07/03/2025
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