Healthcare Provider Details

I. General information

NPI: 1598970485
Provider Name (Legal Business Name): DEBRA KARLA WHALEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2007
Last Update Date: 02/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16929 FRANCES ST STE 101
OMAHA NE
68130-4684
US

IV. Provider business mailing address

555 N 30TH ST
OMAHA NE
68131-2136
US

V. Phone/Fax

Practice location:
  • Phone: 402-758-5125
  • Fax: 402-758-5283
Mailing address:
  • Phone: 402-280-8100
  • Fax: 402-280-8103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number23980
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: