Provider Demographics
NPI:1407668205
Name:DIVIS, RAMONA JAYNE
Entity type:Individual
Prefix:
First Name:RAMONA
Middle Name:JAYNE
Last Name:DIVIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2974 17TH AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NE
Mailing Address - Zip Code:68601-1942
Mailing Address - Country:US
Mailing Address - Phone:402-910-9002
Mailing Address - Fax:
Practice Address - Street 1:3100 23RD ST STE 25
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NE
Practice Address - Zip Code:68601-3161
Practice Address - Country:US
Practice Address - Phone:402-910-9002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-21
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion