Basic Information
| Provider Information | |||||||||
| NPI: | 1922115799 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCGIVNEY-LIECHTI | ||||||||
| FirstName: | KAREN | ||||||||
| MiddleName: | EILEEN | ||||||||
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| Credential: | CNM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8020 O ST | ||||||||
| Address2: | |||||||||
| City: | LINCOLN | ||||||||
| State: | NE | ||||||||
| PostalCode: | 685102561 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4024886370 | ||||||||
| FaxNumber: | 4024884393 | ||||||||
| Practice Location | |||||||||
| Address1: | 8020 O ST | ||||||||
| Address2: | |||||||||
| City: | LINCOLN | ||||||||
| State: | NE | ||||||||
| PostalCode: | 685102561 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4024886370 | ||||||||
| FaxNumber: | 4024884393 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/25/2006 | ||||||||
| LastUpdateDate: | 11/22/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367A00000X | 120032 | NE | Y | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
ID Information
| ID | Type | State | Issuer | Description | 47082083213 | 05 | NE | MEDICAID |