Provider Demographics
NPI:1356162879
Name:KALKOFEN, TINA YVONNE
Entity type:Individual
Prefix:MS
First Name:TINA
Middle Name:YVONNE
Last Name:KALKOFEN
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:PO BOX 344
Mailing Address - Street 2:
Mailing Address - City:OSHKOSH
Mailing Address - State:NE
Mailing Address - Zip Code:69154-0344
Mailing Address - Country:US
Mailing Address - Phone:307-259-9761
Mailing Address - Fax:
Practice Address - Street 1:411 W 4TH ST
Practice Address - Street 2:
Practice Address - City:OSHKOSH
Practice Address - State:NE
Practice Address - Zip Code:69154-5024
Practice Address - Country:US
Practice Address - Phone:308-299-8092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-17
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide