Basic Information
| Provider Information | |||||||||
| NPI: | 1790766608 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NEBBE | ||||||||
| FirstName: | CARVER | ||||||||
| MiddleName: | WILLIAM | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | ISU THIELEN STUDNET HEALTH CTR | ||||||||
| Address2: | 2260 THIELEN STUDENT HEALTH CENTER | ||||||||
| City: | AMES | ||||||||
| State: | IA | ||||||||
| PostalCode: | 500110001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5152945802 | ||||||||
| FaxNumber: | 5152947180 | ||||||||
| Practice Location | |||||||||
| Address1: | 2260 THIELEN STUDENT HEALTH | ||||||||
| Address2: | |||||||||
| City: | AMES | ||||||||
| State: | IA | ||||||||
| PostalCode: | 500112280 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5152945802 | ||||||||
| FaxNumber: | 5152947180 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/08/2005 | ||||||||
| LastUpdateDate: | 05/20/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 35329 | IA | N | Allopathic & Osteopathic Physicians | Family Medicine | 2084B0040X | MD-35329 | IA | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Behavioral Neurology & Neuropsychiatry | 2084P0800X | MD-35329 | IA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | 70089 | 01 | IA | BLUE CROSS BLUE SHIELD | OTHER |