Provider Demographics
NPI:1952682411
Name:QUALLEY, JAMI SUE (DC)
Entity Type:Individual
Prefix:
First Name:JAMI
Middle Name:SUE
Last Name:QUALLEY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:JAMI
Other - Middle Name:SUE
Other - Last Name:HOCKENBARY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:313 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:VALENTINE
Mailing Address - State:NE
Mailing Address - Zip Code:69201-1841
Mailing Address - Country:US
Mailing Address - Phone:402-376-8055
Mailing Address - Fax:402-376-8075
Practice Address - Street 1:313 N MAIN ST
Practice Address - Street 2:
Practice Address - City:VALENTINE
Practice Address - State:NE
Practice Address - Zip Code:69201-1841
Practice Address - Country:US
Practice Address - Phone:402-376-8055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-29
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1682111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10026102200Medicaid
NENA1966Medicare PIN