Provider Demographics
NPI:1912627555
Name:BOCKOVEN, NICKOLAS ALAN (PA-C)
Entity Type:Individual
Prefix:MR
First Name:NICKOLAS
Middle Name:ALAN
Last Name:BOCKOVEN
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:9850 NICHOLAS ST STE 250
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-2191
Mailing Address - Country:US
Mailing Address - Phone:402-399-9990
Mailing Address - Fax:402-399-9851
Practice Address - Street 1:5816 LAFAYETTE AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68132-1337
Practice Address - Country:US
Practice Address - Phone:402-641-3135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-01
Last Update Date:2023-05-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NE29892086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery