Provider Demographics
NPI:1144526393
Name:SCRIVNER, KIMBERLY DAWN
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:DAWN
Last Name:SCRIVNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2935 PINE LAKE RD STE F
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-6009
Mailing Address - Country:US
Mailing Address - Phone:402-261-4017
Mailing Address - Fax:402-261-9185
Practice Address - Street 1:2935 PINE LAKE RD STE F
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-6009
Practice Address - Country:US
Practice Address - Phone:402-261-4017
Practice Address - Fax:402-261-9185
Is Sole Proprietor?:No
Enumeration Date:2011-02-07
Last Update Date:2014-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator