| Barbara K Clinkenbeard Pc | |
|
13911 Gold Cir Ste 210 Omaha NE 68144-2376 | |
| (402) 333-6950 | |
| (402) 333-6944 |
| Full Name | Barbara K Clinkenbeard Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 13911 Gold Cir Ste 210, Omaha, Nebraska |
| Authorized Official Name and Position | Barbara K Clinkembeard (PRESIDENT) |
| Authorized Official Contact | 4029539610 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Barbara K Clinkenbeard Pc 13911 Gold Cir Ste 210 Omaha NE 68144-2376 Ph: (402) 333-6950 | Barbara K Clinkenbeard Pc 13911 Gold Cir Ste 210 Omaha NE 68144-2376 Ph: (402) 333-6950 |
| NPI Number | 1578113130 |
|---|---|
| Provider Enumeration Date | 09/16/2019 |
| Last Update Date | 08/27/2021 |
| Certification Date | 08/27/2021 |
| Medicare PECOS PAC ID | 0840522447 |
|---|---|
| Medicare Enrollment ID | O20191031001959 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578113130 | NPI | - | NPPES |
| 10026806600 | Medicaid | NE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Secondary |
| Provider Name | Barbara K Clinkenbeard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497761415 PECOS PAC ID: 4486661170 Enrollment ID: I20060824000217 |
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