Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 19028 | NE |
NPI | 1063462471 |
---|---|
Provider Name | Dr. Jeffrey T Marple |
First Address | Lincoln, NE 68510-2468 |
Second Address | Lincoln, NE 68510-2468 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
91175934813 | (05) | NE |
E11811 | (02) |