Provider Demographics
NPI:1093043655
Name:CUMRO, JEFFREY LYNN (DC)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:LYNN
Last Name:CUMRO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 1ST CORSO
Mailing Address - Street 2:
Mailing Address - City:NEBRASKA CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68410-2407
Mailing Address - Country:US
Mailing Address - Phone:402-873-6999
Mailing Address - Fax:402-873-3302
Practice Address - Street 1:605 1ST CORSO
Practice Address - Street 2:
Practice Address - City:NEBRASKA CITY
Practice Address - State:NE
Practice Address - Zip Code:68410-2407
Practice Address - Country:US
Practice Address - Phone:402-873-6999
Practice Address - Fax:402-873-3302
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-19
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1578111NN0400X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE1396073953OtherGROUP NPI
NE100258274Medicaid