Provider Demographics
NPI:1508286659
Name:ECKLUND, DONNA
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:ECKLUND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:
Other - Last Name:HARDING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 2583
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68848-2583
Mailing Address - Country:US
Mailing Address - Phone:308-234-6029
Mailing Address - Fax:308-237-4792
Practice Address - Street 1:125 E 31ST ST
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847
Practice Address - Country:US
Practice Address - Phone:308-234-6029
Practice Address - Fax:308-237-4792
Is Sole Proprietor?:No
Enumeration Date:2014-04-16
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE470522836Medicaid