Individual
LENNIE J DEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
309 NELSON ST, CAMBRIDGE, NE 69022-3592
(308) 697-1419
(308) 697-3278
Mailing address
PO BOX 488, CAMBRIDGE, NE 69022
(308) 697-1526
(308) 697-3278
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
NE16867
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
16867
—
NE
Enumeration date
11/02/2006
Last updated
01/05/2010
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