Provider Demographics
NPI:1215933007
Name:THURMAN, CAROL (PHD)
Entity type:Individual
Prefix:DR
First Name:CAROL
Middle Name:
Last Name:THURMAN
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 1:1116 N 57TH RD
Mailing Address - Street 2:
Mailing Address - City:NEBRASKA CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68410-6136
Mailing Address - Country:US
Mailing Address - Phone:402-874-9050
Mailing Address - Fax:402-874-9050
Practice Address - Street 1:1116 N 57TH RD
Practice Address - Street 2:
Practice Address - City:NEBRASKA CITY
Practice Address - State:NE
Practice Address - Zip Code:68410-6200
Practice Address - Country:US
Practice Address - Phone:402-874-9050
Practice Address - Fax:402-874-9050
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-26
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE542103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE08156OtherBLUECROSS/BLUESHIELD
NE08156OtherBLUECROSS/BLUESHIELD
P20447Medicare UPIN