Provider Demographics
NPI:1912189903
Name:VARNEY, NILS ROBERTS (PHD)
Entity Type:Individual
Prefix:DR
First Name:NILS
Middle Name:ROBERTS
Last Name:VARNEY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 CAMBORNE CIR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52245-1540
Mailing Address - Country:US
Mailing Address - Phone:319-338-7266
Mailing Address - Fax:
Practice Address - Street 1:48 CAMBORNE CIR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245-1540
Practice Address - Country:US
Practice Address - Phone:319-338-7266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-30
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA314103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist