Provider Demographics
NPI:1336150796
Name:JONES-THURMAN, ROSANNA M (PHD)
Entity type:Individual
Prefix:DR
First Name:ROSANNA
Middle Name:M
Last Name:JONES-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 1:6790 GROVER ST
Mailing Address - Street 2:SUITE #100
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68106-3642
Mailing Address - Country:US
Mailing Address - Phone:402-715-4321
Mailing Address - Fax:402-715-4343
Practice Address - Street 1:6790 GROVER ST
Practice Address - Street 2:SUITE 100
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68106-3642
Practice Address - Country:US
Practice Address - Phone:402-715-4321
Practice Address - Fax:402-715-4343
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2010-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE539103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025352700Medicaid
NE156234OtherVALUEOPTIONS PROVIDER ID
NE80016OtherBC BS PROVIDER NUMBER
NE80016OtherBC BS PROVIDER NUMBER
NE542177758OtherTAX ID NUMBER
NE156234OtherVALUEOPTIONS PROVIDER ID