Provider Demographics
NPI:1477856987
Name:REICKS, BRANDON L (PA)
Entity Type:Individual
Prefix:
First Name:BRANDON
Middle Name:L
Last Name:REICKS
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Gender:M
Credentials:PA
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Mailing Address - Street 1:982035 NEBRASKA MEDICAL CTR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68198-2035
Mailing Address - Country:US
Mailing Address - Phone:402-559-9614
Mailing Address - Fax:402-559-7779
Practice Address - Street 1:982035 NEBRASKA MEDICAL CTR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68198-2035
Practice Address - Country:US
Practice Address - Phone:402-559-9614
Practice Address - Fax:402-559-7779
Is Sole Proprietor?:No
Enumeration Date:2010-12-06
Last Update Date:2013-10-10
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant