Provider Demographics
NPI:1568409001
Name:LIST, DEAN ALLAN (NP)
Entity Type:Individual
Prefix:MR
First Name:DEAN
Middle Name:ALLAN
Last Name:LIST
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8511 AUGUSTA DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68526-9572
Mailing Address - Country:US
Mailing Address - Phone:402-328-2907
Mailing Address - Fax:888-965-0959
Practice Address - Street 1:8511 AUGUSTA DR
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68526-9572
Practice Address - Country:US
Practice Address - Phone:402-328-8833
Practice Address - Fax:888-965-0959
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE110412363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health