1083747935 NPI number — MS. JAMIE LEE ADDINK BACHELOR OF SCIENCE

Table of content: MS. JAMIE LEE ADDINK BACHELOR OF SCIENCE (NPI 1083747935)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083747935 NPI number — MS. JAMIE LEE ADDINK BACHELOR OF SCIENCE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ADDINK
Provider First Name:
JAMIE
Provider Middle Name:
LEE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
BACHELOR OF SCIENCE
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
JENSEN
Provider Other First Name:
JAMIE
Provider Other Middle Name:
LEE
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
BS
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1083747935
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
600 SOUTH 13TH STREET
Provider Second Line Business Mailing Address:
BEHAVIORAL HEALTH SPECIALISTS INC
Provider Business Mailing Address City Name:
NORFOLK
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68701
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-370-3140
Provider Business Mailing Address Fax Number:
402-370-3373

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
600 SOUTH 13TH STREET
Provider Second Line Business Practice Location Address:
BEHAVIORAL HEALTH SPECIALISTS
Provider Business Practice Location Address City Name:
NORFOLK
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-370-3140
Provider Business Practice Location Address Fax Number:
402-370-3372
Provider Enumeration Date:
03/13/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 171M00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)