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NPI Code Detail

MEDICARE: JODY SPALDING M.A. CCC-A

MEDICARE: JODY SPALDING M.A. CCC-A
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1231H00000XAudiologist125NE
2237600000XAudiologist-Hearing Aid Fitter572NE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
137024OTHERNEBCBS

General Provider Information

NPI Number : 1144283953
Entity Type Code : Individual
Provider Name (Legal Business Name) : JODY SPALDING M.A. CCC-A
Provider Business Mailing Address
First Line : 555 N 30TH ST
Second Line :
City : OMAHA
State : NE
Zip : 68131-2136
Country : US
Telephone Number : 402-498-6675
Fax Number : 402-452-5015
Provider Business Practice Location Address
First Line : 555 N 30TH ST
Second Line :
City : OMAHA
State : NE
Zip : 68131-2136
Country : US
Telephone Number : 402-498-6675
Fax Number : 402-452-5015
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2006
Last Update Date : 04/05/2010

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