Provider Demographics
NPI:1912382409
Name:YAHNKE, KIMBERLEY ANN COX (OTR)
Entity Type:Individual
Prefix:
First Name:KIMBERLEY
Middle Name:ANN COX
Last Name:YAHNKE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 2ND ST
Mailing Address - Street 2:
Mailing Address - City:DODGE
Mailing Address - State:NE
Mailing Address - Zip Code:68633-3555
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15037 CHERRY ST
Practice Address - Street 2:
Practice Address - City:BENNINGTON
Practice Address - State:NE
Practice Address - Zip Code:68007
Practice Address - Country:US
Practice Address - Phone:402-250-0474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-24
Last Update Date:2020-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA075029225X00000X
NE1901225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist