Individual
MRS. KATHY ANN NIEMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OPTICIAN
Contact information
Practice address
1104 S 76TH AVE, OMAHA, NE 68124-1559
(402) 955-2020
(402) 955-2025
Mailing address
1104 S 76TH AVE, OMAHA, NE 68124-1559
(402) 955-2020
(402) 955-2025
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100-25-2246-00
—
NE
Enumeration date
07/19/2011
Last updated
09/21/2023
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