Provider Demographics
NPI:1639771603
Name:NEVERMANN, BARBARA (LMT, CR)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:NEVERMANN
Suffix:
Gender:F
Credentials:LMT, CR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7666
Mailing Address - Street 2:
Mailing Address - City:URBANDALE
Mailing Address - State:IA
Mailing Address - Zip Code:50323-7666
Mailing Address - Country:US
Mailing Address - Phone:515-867-1419
Mailing Address - Fax:
Practice Address - Street 1:1304 NW 92ND ST
Practice Address - Street 2:
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-6276
Practice Address - Country:US
Practice Address - Phone:515-867-1419
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-13
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA073578225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner