Provider Demographics
NPI:1932221033
Name:WHEELER, ELIZABETH JOHANNA (PHD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:JOHANNA
Last Name:WHEELER
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 1:2534 A ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68502-1838
Mailing Address - Country:US
Mailing Address - Phone:402-484-6759
Mailing Address - Fax:
Practice Address - Street 1:2534 A ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68502-1838
Practice Address - Country:US
Practice Address - Phone:402-484-6759
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1114101YM0800X
NE100717103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE084541OtherBCBSNE