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General NPI Number Information
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NPI Number | 1083804967
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Entity Type | Individual
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Provider Name | COREEN ANN PERDEW OTR/L
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Gender | Female
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Dates
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Enumeration Date | 07/27/2007
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Last Update Date | 05/22/2023
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Provider Practice Location Address
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Address Line | 7100 S 32ND ST
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City | LINCOLN
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State | NE
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Zip | 68516-4866
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Country | US
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Telephone | 402-239-9866
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Fax |
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Provider Business Mailing Address
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Address Line | 1110 N 10TH ST PO BOX 278
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City | BEATRICE
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State | NE
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Zip | 68310-2039
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Country | US
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Telephone | 402-223-7309
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Fax | 402-223-6511
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 675
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License Number State | NE
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