Healthcare Provider Details

I. General information

NPI: 1649108820
Provider Name (Legal Business Name): SHELLY MARIE DEBUHR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5801 HIDCOTE DR STE 300
LINCOLN NE
68516-5569
US

IV. Provider business mailing address

5444 ERVIN ST
LINCOLN NE
68504-1761
US

V. Phone/Fax

Practice location:
  • Phone: 402-665-4687
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: