Provider Demographics
NPI:1043496243
Name:DOANE, CHELSIE N (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:CHELSIE
Middle Name:N
Last Name:DOANE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CHELSIE
Other - Middle Name:N
Other - Last Name:LAMMERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:7440 S 91ST ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68526-9797
Mailing Address - Country:US
Mailing Address - Phone:402-489-6555
Mailing Address - Fax:402-328-3770
Practice Address - Street 1:3515 RICHMOND CIR
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-4965
Practice Address - Country:US
Practice Address - Phone:308-381-8636
Practice Address - Fax:308-381-8622
Is Sole Proprietor?:No
Enumeration Date:2008-01-17
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1357363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47070592313Medicaid
NE10026072400Medicaid
NE10026072300Medicaid
NENA1939016Medicare PIN
NE10026072300Medicaid
NEP00616924Medicare PIN
NE47070592313Medicaid
NENA1080031Medicare PIN