Provider Demographics
NPI:1659627875
Name:TERNUS, HOLLY E (OD)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:E
Last Name:TERNUS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:E
Other - Last Name:PIEPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:9900 NICHOLAS ST
Mailing Address - Street 2:STE 250
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-2214
Mailing Address - Country:US
Mailing Address - Phone:402-493-6500
Mailing Address - Fax:402-493-4370
Practice Address - Street 1:9900 NICHOLAS ST
Practice Address - Street 2:STE 250
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-2214
Practice Address - Country:US
Practice Address - Phone:402-493-6500
Practice Address - Fax:402-493-4370
Is Sole Proprietor?:No
Enumeration Date:2012-07-25
Last Update Date:2016-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1458152W00000X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB156834Medicare PIN