Provider Demographics
NPI:1134487317
Name:PSYCHO-ONCOLOGY,INC
Entity Type:Organization
Organization Name:PSYCHO-ONCOLOGY,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:CLINKENBEARD
Authorized Official - Suffix:
Authorized Official - Credentials:MS,NP
Authorized Official - Phone:402-504-3714
Mailing Address - Street 1:7205 W CENTER RD
Mailing Address - Street 2:100
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-2380
Mailing Address - Country:US
Mailing Address - Phone:402-504-3714
Mailing Address - Fax:402-504-3714
Practice Address - Street 1:7205 W CENTER RD
Practice Address - Street 2:100
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-2380
Practice Address - Country:US
Practice Address - Phone:402-504-3714
Practice Address - Fax:402-504-3714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-25
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE110789363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty