Healthcare Provider Details

I. General information

NPI: 1184732943
Provider Name (Legal Business Name): WESLEY ELLWYN SIME PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 07/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 S 68TH STREET PL SUITE #500
LINCOLN NE
68510-2475
US

IV. Provider business mailing address

1919 SOUTH 40TH STREET SUITE #335
LINCOLN NE
68506-5286
US

V. Phone/Fax

Practice location:
  • Phone: 402-434-2730
  • Fax: 402-434-3970
Mailing address:
  • Phone: 402-420-2500
  • Fax: 402-420-2501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number367
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: