Provider Demographics
NPI:1659189322
Name:THORNDIKE, DEBRA JEAN
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:JEAN
Last Name:THORNDIKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 N 35TH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68503-3317
Mailing Address - Country:US
Mailing Address - Phone:509-431-0089
Mailing Address - Fax:
Practice Address - Street 1:808 P ST STE 206
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68508-1383
Practice Address - Country:US
Practice Address - Phone:509-431-0089
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-26
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion