Provider Demographics
NPI:1487950879
Name:ROLFSMEYER, DEAN ♠ E (HIS)
Entity type:Individual
Prefix:MR
First Name:DEAN ♠
Middle Name:E
Last Name:ROLFSMEYER
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 W DAWES AVE
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68521-3920
Mailing Address - Country:US
Mailing Address - Phone:402-474-3955
Mailing Address - Fax:402-474-3955
Practice Address - Street 1:500 MARKET ST
Practice Address - Street 2:
Practice Address - City:BEATRICE
Practice Address - State:NE
Practice Address - Zip Code:68310-4403
Practice Address - Country:US
Practice Address - Phone:402-474-3955
Practice Address - Fax:402-474-3955
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-01
Last Update Date:2011-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE612174400000X, 237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE$$$$$$$$$00Medicaid