Provider Demographics
NPI:1942379516
Name:BOCK, JANET MAE (MSN, APRN, B)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:MAE
Last Name:BOCK
Suffix:
Gender:F
Credentials:MSN, APRN, B
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13643 W SARGENT RD
Mailing Address - Street 2:
Mailing Address - City:BEATRICE
Mailing Address - State:NE
Mailing Address - Zip Code:68310-7056
Mailing Address - Country:US
Mailing Address - Phone:402-223-3167
Mailing Address - Fax:
Practice Address - Street 1:3000 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:BEATRICE
Practice Address - State:NE
Practice Address - Zip Code:68310-3319
Practice Address - Country:US
Practice Address - Phone:402-223-6859
Practice Address - Fax:402-223-7553
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE110019363LF0000X, 363LP0808X, 363LP0808X
NE103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025617500Medicaid
NE39240OtherBCBSNE - NEW BEGINNINGS
NE10025637300Medicaid
KS200587230AMedicaid
NENA1190001Medicare PIN
NE096938002Medicare PIN
R98983Medicare UPIN
KS200587230AMedicaid