Provider Demographics
NPI:1093510653
Name:BIRDINE, FRANKLIN DVON
Entity type:Individual
Prefix:
First Name:FRANKLIN
Middle Name:DVON
Last Name:BIRDINE
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 1:7016 MINNE LUSA BLVD
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68112-3113
Mailing Address - Country:US
Mailing Address - Phone:515-313-6348
Mailing Address - Fax:
Practice Address - Street 1:7016 MINNE LUSA BLVD
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68112-3113
Practice Address - Country:US
Practice Address - Phone:515-313-6348
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-18
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist