Individual
MRS. KIMBERLEY A DEATS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.P.A.S, P.A.-C
Contact information
Practice address
909 N 96TH ST, SUITE 201, OMAHA, NE 68114-2497
(402) 330-4555
(402) 934-0945
Mailing address
909 N 96TH ST, SUITE 201, OMAHA, NE 68114-2497
(402) 330-4555
(402) 934-0945
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1146
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00166317
RAILROAD MEDICARE
NE
Enumeration date
08/31/2006
Last updated
07/30/2013
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