Provider Demographics
NPI:1669457610
Name:SVOBODA, AMY DEANN
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:DEANN
Last Name:SVOBODA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2115 N KANSAS AVE
Mailing Address - Street 2:MIDWEST EAR NOSE & THROAT SPECIALISTS PC
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901-2644
Mailing Address - Country:US
Mailing Address - Phone:402-463-2431
Mailing Address - Fax:402-462-2486
Practice Address - Street 1:2115 N KANSAS AVE
Practice Address - Street 2:MIDWEST EAR NOSE & THROAT SPECIALISTS PC
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-2644
Practice Address - Country:US
Practice Address - Phone:402-463-2431
Practice Address - Fax:402-462-2486
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE581237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47053662301Medicaid