Provider Demographics
NPI:1518911494
Name:YORK, CARRIE A (DC)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:A
Last Name:YORK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6122
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-0122
Mailing Address - Country:US
Mailing Address - Phone:402-261-8974
Mailing Address - Fax:402-261-8976
Practice Address - Street 1:5801 S 58TH ST
Practice Address - Street 2:SUITE C
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-3664
Practice Address - Country:US
Practice Address - Phone:402-261-8974
Practice Address - Fax:402-261-8976
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-22
Last Update Date:2012-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1362111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025724900Medicaid
NE10025724900Medicaid