Provider Demographics
NPI:1750840302
Name:BICKNASE, SEAN (DC)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:BICKNASE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 N 48TH ST STE I
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68504-3599
Mailing Address - Country:US
Mailing Address - Phone:402-604-0711
Mailing Address - Fax:
Practice Address - Street 1:4645 NORMAL BLVD STE 200
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-5597
Practice Address - Country:US
Practice Address - Phone:402-483-6633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-13
Last Update Date:2019-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1887111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE1750840302Medicaid