Individual
RANDOLPH THURBER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CSW
Contact information
Practice address
2501 Q ST, STE 111, LINCOLN, NE 68503-3539
(402) 890-5531
Mailing address
2501 Q ST, STE 111, LINCOLN, NE 68503-3539
(402) 890-5531
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
172V00000X
Community Health Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025513400
—
NE
Enumeration date
01/08/2014
Last updated
05/30/2014
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