Provider Demographics
NPI:1891252219
Name:HINRICHSEN, SHAYLA
Entity Type:Individual
Prefix:
First Name:SHAYLA
Middle Name:
Last Name:HINRICHSEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6016 S 87TH ST STE 120
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68526-9364
Mailing Address - Country:US
Mailing Address - Phone:531-242-6965
Mailing Address - Fax:531-242-5285
Practice Address - Street 1:6016 S 87TH ST STE 120
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68526-9364
Practice Address - Country:US
Practice Address - Phone:531-242-6965
Practice Address - Fax:531-242-5285
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-21
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE112717363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health