Provider Demographics
NPI:1457546145
Name:NANCY A DOB, OD,PC
Entity type:Organization
Organization Name:NANCY A DOB, OD,PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:A
Authorized Official - Last Name:DOB
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:402-362-3313
Mailing Address - Street 1:PO BOX 342
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:NE
Mailing Address - Zip Code:68361-0342
Mailing Address - Country:US
Mailing Address - Phone:402-773-5616
Mailing Address - Fax:
Practice Address - Street 1:210 N SAUNDERS
Practice Address - Street 2:
Practice Address - City:SUTTON
Practice Address - State:NE
Practice Address - Zip Code:68979
Practice Address - Country:US
Practice Address - Phone:402-773-5616
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-06
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE931152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE0183380003Medicare NSC