Provider Demographics
NPI:1710090568
Name:JEFFREY, LOUISE KURDYS (PHD)
Entity Type:Individual
Prefix:DR
First Name:LOUISE
Middle Name:KURDYS
Last Name:JEFFREY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 FORTUNE DRIVE
Mailing Address - Street 2:SUITE 150
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68046-3421
Mailing Address - Country:US
Mailing Address - Phone:402-980-2068
Mailing Address - Fax:402-504-6429
Practice Address - Street 1:555 FORTUNE DR
Practice Address - Street 2:
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68046-3421
Practice Address - Country:US
Practice Address - Phone:402-980-2068
Practice Address - Fax:402-504-6429
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE227103G00000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE100253414-00Medicaid
NE80013OtherBC/
NE100253414-00Medicaid