Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 26301 | NE |
N | 111NI0900X | Internist | 26301 | NE |
NPI | 1003078528 |
---|---|
Provider Name | Abbie K Ray-Deering |
First Address | Omaha, NE 68103-0755 |
Second Address | Omaha, NE 68118-2244 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2008 |
Last Update Date | 18/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1003078528 | (05) | IA |
470687317-16 | (05) | NE |