Individual
NICOLE ALEXIS GOLIBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
3685 N 129TH ST, OMAHA, NE 68164-5211
(402) 595-3993
(402) 595-1132
Mailing address
988102 NEBRASKA MEDICAL CTR, OMAHA, NE 68198-8102
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
001905
IA
363A00000X
Physician Assistant
Primary
1361
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10026480100
—
NE
05
—
47068731734
—
NE
05
—
47068731741
—
NE
05
—
47068731749
—
NE
05
—
47068731797
—
NE
Enumeration date
05/09/2008
Last updated
09/26/2018
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