Provider Demographics
NPI:1841091238
Name:STUBBS, DONALD DEAN
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:DEAN
Last Name:STUBBS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5001 NW 1ST ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68521-4496
Mailing Address - Country:US
Mailing Address - Phone:402-440-5878
Mailing Address - Fax:
Practice Address - Street 1:3130 W 15TH ST
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-2425
Practice Address - Country:US
Practice Address - Phone:308-379-8287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-21
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant