Provider Demographics
NPI:1093785446
Name:NICKEL-DRABEK, EVA M (MS, CPC, LMPH)
Entity Type:Individual
Prefix:MRS
First Name:EVA
Middle Name:M
Last Name:NICKEL-DRABEK
Suffix:
Gender:F
Credentials:MS, CPC, LMPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1709 W 39TH ST
Mailing Address - Street 2:STE 1
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68845-8323
Mailing Address - Country:US
Mailing Address - Phone:308-234-6029
Mailing Address - Fax:308-237-4792
Practice Address - Street 1:1709 W 39TH ST
Practice Address - Street 2:STE 1
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68845-8323
Practice Address - Country:US
Practice Address - Phone:308-234-6029
Practice Address - Fax:308-237-4792
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NELMHP1781101Y00000X
NECPC1068101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47077781326Medicaid
098125Medicare ID - Type Unspecified