Provider Demographics
NPI:1891533584
Name:SPONY-LEYBOLD, DAPHNE MERLE (REGISTERED NURSE)
Entity type:Individual
Prefix:MS
First Name:DAPHNE
Middle Name:MERLE
Last Name:SPONY-LEYBOLD
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:MS
Other - First Name:DAPHNE
Other - Middle Name:MERLE
Other - Last Name:SPONY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:420 VICTORY PARK DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-2484
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:420 VICTORY PARK DR
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-2484
Practice Address - Country:US
Practice Address - Phone:402-489-3802
Practice Address - Fax:612-725-1308
Is Sole Proprietor?:No
Enumeration Date:2024-07-17
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE60237163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care