Provider Demographics
NPI:1841735362
Name:KANKOVSKY, MEAGAN
Entity Type:Individual
Prefix:MS
First Name:MEAGAN
Middle Name:
Last Name:KANKOVSKY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MEAGAN
Other - Middle Name:
Other - Last Name:DUNKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:988102 NEBRASKA MEDICAL CENTER
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68198-8102
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:42ND @ DEWEY ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68198-1023
Practice Address - Country:US
Practice Address - Phone:402-552-6007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-20
Last Update Date:2019-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE5153101YM0800X, 101YM0800X
NE70731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical