Provider Demographics
NPI:1427130095
Name:DAVIDSON, DEBORAH KAY (DO)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:KAY
Last Name:DAVIDSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:DEBORAH
Other - Middle Name:NYBERG
Other - Last Name:DAVIDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:5440 SOUTH STREET
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506
Mailing Address - Country:US
Mailing Address - Phone:402-465-1900
Mailing Address - Fax:402-465-1940
Practice Address - Street 1:5440 SOUTH STREET
Practice Address - Street 2:SUITE 200
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506
Practice Address - Country:US
Practice Address - Phone:402-465-1900
Practice Address - Fax:402-465-1940
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE115207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE90984Medicare PIN