Individual ProviderJulia NissenSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersPractice Address4614 S 132nd St, Omaha, NE 68137-1764(402) 330-3211PECOS EnrollmentBased on the most recent information from CMS, provider Julia Nissen does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1346854015Provider TypeIndividualFull NameNissen, JuliaCredentialSLPGenderFemaleSole ProprietorNoEnumeration Date9/1/2020Last Updated7/8/2021Contact InformationPractice LocationPractice Address4614 S 132nd St, Omaha, NE 68137-1764Phone(402) 330-3211Fax(402) 330-5970Mailing LocationMailing Address4614 S 132nd St, Omaha, NE 68137-1764Phone(402) 330-3211Fax(402) 330-5970Provider TaxonomiesCodeDescriptionLicenseCode235Z00000XPrimaryDescriptionSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersLicense2530NebraskaCode235Z00000XDescriptionSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersLicense794NebraskaProvider IdentifiersIDDescriptionIssuerID47065477700DescriptionMedicaidIssuerUnlistedNebraska