Provider Demographics
NPI:1891582763
Name:KADAVY, THOMAS LEE
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:LEE
Last Name:KADAVY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8310 VINE ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68505-2040
Mailing Address - Country:US
Mailing Address - Phone:402-432-3291
Mailing Address - Fax:
Practice Address - Street 1:8310 VINE ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68505-2040
Practice Address - Country:US
Practice Address - Phone:402-432-3291
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-23
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide