Individual
NICOLE LYNN HENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2222 S 16TH ST STE 240, LINCOLN, NE 68502-3764
(402) 323-7260
(402) 323-7266
Mailing address
PO BOX 209, NORFOLK, NE 68702-0209
(402) 379-2322
(402) 379-9533
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1454
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10026139600
—
NE
01
—
1454
PHYSICIAN ASSISTANT LICENSE
NE
Enumeration date
07/14/2009
Last updated
03/24/2021
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