Provider Demographics
NPI:1013801463
Name:NIKSICK, KATELYN ANN (HIGH SCHOOL DIPLOMA)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:ANN
Last Name:NIKSICK
Suffix:
Gender:F
Credentials:HIGH SCHOOL DIPLOMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12708 AMES PLZ APT 303
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68164-6934
Mailing Address - Country:US
Mailing Address - Phone:402-981-4369
Mailing Address - Fax:
Practice Address - Street 1:3616 S 89TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-3932
Practice Address - Country:US
Practice Address - Phone:402-714-3920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEH14074001372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No372600000XNursing Service Related ProvidersAdult Companion