Provider Demographics
NPI:1497034045
Name:NUNAMAKER, JOHN E (LIMHP)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:E
Last Name:NUNAMAKER
Suffix:
Gender:M
Credentials:LIMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 641130
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68164-7130
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3308 SAMSON WAY
Practice Address - Street 2:SUITE 203
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68123-3234
Practice Address - Country:US
Practice Address - Phone:402-717-7681
Practice Address - Fax:402-291-8806
Is Sole Proprietor?:No
Enumeration Date:2011-08-15
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE771101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health