Provider Demographics
NPI:1578825113
Name:DEPUE, ADAM DANIEL (PA-C)
Entity Type:Individual
Prefix:MR
First Name:ADAM
Middle Name:DANIEL
Last Name:DEPUE
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:2222 S 16TH STREET
Mailing Address - Street 2:STE 305
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68502-3762
Mailing Address - Country:US
Mailing Address - Phone:402-488-3002
Mailing Address - Fax:402-483-8787
Practice Address - Street 1:2222 S 16TH ST
Practice Address - Street 2:STE 305
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68502-3762
Practice Address - Country:US
Practice Address - Phone:402-488-3002
Practice Address - Fax:402-483-8787
Is Sole Proprietor?:No
Enumeration Date:2012-06-11
Last Update Date:2016-09-17
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Provider Licenses
StateLicense IDTaxonomies
NE1661363A00000X
NE363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant