Provider Demographics
NPI:1922115799
Name:MCGIVNEY-LIECHTI, KAREN EILEEN (CNM)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:EILEEN
Last Name:MCGIVNEY-LIECHTI
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8020 O ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-2561
Mailing Address - Country:US
Mailing Address - Phone:402-488-6370
Mailing Address - Fax:402-488-4393
Practice Address - Street 1:8020 O ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-2561
Practice Address - Country:US
Practice Address - Phone:402-488-6370
Practice Address - Fax:402-488-4393
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2017-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE120032367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47082083213Medicaid
278729Medicare ID - Type Unspecified
NE47082083213Medicaid