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General NPI Number Information
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NPI Number | 1396205753
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Entity Type | Individual
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Provider Name | MACY MANDELINE DEEDS APRN
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Gender | Female
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Dates
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Enumeration Date | 03/21/2019
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Last Update Date | 03/07/2025
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Provider Practice Location Address
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Address Line | 2717 S 108TH ST STE 200
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City | OMAHA
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State | NE
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Zip | 68144-4811
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Country | US
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Telephone | 402-933-8201
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Fax | 402-933-8301
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Provider Business Mailing Address
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Address Line | 1001 S OHIO ST
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City | SALINA
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State | KS
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Zip | 67401-5364
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Country | US
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Telephone | 785-827-6453
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Fax | 785-823-1255
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 53-78509-051
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 112734
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License Number State | NE
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