Provider Demographics
NPI:1083804967
Name:PERDEW, COREEN ANN (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:COREEN
Middle Name:ANN
Last Name:PERDEW
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 N 10TH ST
Mailing Address - Street 2:PO BOX 278
Mailing Address - City:BEATRICE
Mailing Address - State:NE
Mailing Address - Zip Code:68310-2039
Mailing Address - Country:US
Mailing Address - Phone:402-223-7309
Mailing Address - Fax:402-223-6511
Practice Address - Street 1:7100 S 32ND ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-4866
Practice Address - Country:US
Practice Address - Phone:402-239-9866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-27
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE675225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist