MEDICARE: DR. CAROL THURMAN PH.D.

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
1	103T00000X	Psychologist	542	NE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	08156	OTHER	NE	BLUECROSS/BLUESHIELD

General Provider Information

NPI Number	:	1215933007
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CAROL THURMAN PH.D.

Provider Business Mailing Address
First Line	:	1116 N 57TH RD
Second Line	:
City	:	NEBRASKA CITY
State	:	NE
Zip	:	68410-6136
Country	:	US
Telephone Number	:	402-874-9050
Fax Number	:	402-874-9050

Provider Business Practice Location Address
First Line	:	1116 N 57TH RD
Second Line	:
City	:	NEBRASKA CITY
State	:	NE
Zip	:	68410-6200
Country	:	US
Telephone Number	:	402-874-9050
Fax Number	:	402-874-9050

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/26/2005
Last Update Date	:	02/19/2014

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Directions to “ DR. CAROL THURMAN PH.D.” Practice Location

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