Provider Demographics
NPI:1013025006
Name:EBERSPACHER, DEBORAH M (MPT)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:M
Last Name:EBERSPACHER
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:M
Other - Last Name:ROVANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:8055 O ST
Mailing Address - Street 2:STE 300
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-2580
Mailing Address - Country:US
Mailing Address - Phone:402-421-0896
Mailing Address - Fax:402-421-0945
Practice Address - Street 1:555 S 70TH ST
Practice Address - Street 2:RM 2504
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-2462
Practice Address - Country:US
Practice Address - Phone:402-219-7498
Practice Address - Fax:402-421-0945
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2009-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1776208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE02183OtherBCBS
NEP00741137Medicare PIN
280466Medicare PIN