Provider Demographics
NPI:1306724943
Name:WEINAND, KRISTIN ROSE (EDS)
Entity type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:ROSE
Last Name:WEINAND
Suffix:
Gender:F
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19404 RUGGLES CIR
Mailing Address - Street 2:
Mailing Address - City:ELKHORN
Mailing Address - State:NE
Mailing Address - Zip Code:68022-5192
Mailing Address - Country:US
Mailing Address - Phone:402-219-2876
Mailing Address - Fax:
Practice Address - Street 1:20650 GLENN ST
Practice Address - Street 2:
Practice Address - City:ELKHORN
Practice Address - State:NE
Practice Address - Zip Code:68022-2324
Practice Address - Country:US
Practice Address - Phone:402-289-2579
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-22
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE20230016638103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool