Provider Demographics
NPI:1861898058
Name:DOORNINK, BILLIE
Entity type:Individual
Prefix:
First Name:BILLIE
Middle Name:
Last Name:DOORNINK
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 1:7219 S 71ST AVE
Mailing Address - Street 2:
Mailing Address - City:LA VISTA
Mailing Address - State:NE
Mailing Address - Zip Code:68128-2058
Mailing Address - Country:US
Mailing Address - Phone:402-889-1505
Mailing Address - Fax:
Practice Address - Street 1:7219 S 71ST AVE
Practice Address - Street 2:
Practice Address - City:LA VISTA
Practice Address - State:NE
Practice Address - Zip Code:68128-2058
Practice Address - Country:US
Practice Address - Phone:402-889-1505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-14
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker