Provider Demographics
NPI:1780634899
Name:NOKELS, DAWN M (PA-C)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:M
Last Name:NOKELS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8005 FARNAM DR
Mailing Address - Street 2:SUITE 204
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-3426
Mailing Address - Country:US
Mailing Address - Phone:402-502-6970
Mailing Address - Fax:402-502-6930
Practice Address - Street 1:8005 FARNAM DR
Practice Address - Street 2:SUITE 204
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-3426
Practice Address - Country:US
Practice Address - Phone:402-502-6970
Practice Address - Fax:402-502-6930
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2015-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE661363A00000X
NE363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE661OtherNE LICENSE