Provider Demographics
NPI:1285968230
Name:NEREM NEUROPSYCHOLOGICAL SERVICES, PC
Entity type:Organization
Organization Name:NEREM NEUROPSYCHOLOGICAL SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/CLINICAL NEUROPSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DEANN
Authorized Official - Middle Name:LYN
Authorized Official - Last Name:NEREM
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:515-689-6411
Mailing Address - Street 1:6165 NW 86TH ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:IA
Mailing Address - Zip Code:50131-2270
Mailing Address - Country:US
Mailing Address - Phone:515-727-1676
Mailing Address - Fax:
Practice Address - Street 1:6165 NW 86TH ST
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:IA
Practice Address - Zip Code:50131-2270
Practice Address - Country:US
Practice Address - Phone:515-727-1676
Practice Address - Fax:515-727-1682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-23
Last Update Date:2009-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00918103G00000X, 103TA0700X, 103TC2200X, 103TM1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & AgingGroup - Single Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Single Specialty
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental DisabilitiesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAI6004Medicare PIN
IAP55707Medicare UPIN