Provider Demographics
NPI:1780751958
Name:PROBST, NANCY JANE (LADC)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:JANE
Last Name:PROBST
Suffix:
Gender:F
Credentials:LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:419 N 17TH ST
Mailing Address - Street 2:
Mailing Address - City:BEATRICE
Mailing Address - State:NE
Mailing Address - Zip Code:68310-3119
Mailing Address - Country:US
Mailing Address - Phone:402-223-5813
Mailing Address - Fax:
Practice Address - Street 1:1123 N 9TH ST
Practice Address - Street 2:
Practice Address - City:BEATRICE
Practice Address - State:NE
Practice Address - Zip Code:68310-2041
Practice Address - Country:US
Practice Address - Phone:402-228-3386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE313101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE470528515582Medicaid
NE47052851501Medicaid
NE47052851507Medicaid
NE47052851517Medicaid
NE47052851506Medicaid
NE47052851509Medicaid
NE47052851510Medicaid
NE85333OtherBCBS
NE47052851508Medicaid
NE47052851502Medicaid
NE47052851504Medicaid
NE47052851581Medicaid
NE1025208100Medicaid
NE47052851500Medicaid
NE47052851515Medicaid
NE10025207700Medicaid
NE10025208200Medicaid
NE47052851503Medicaid
NE47052851505Medicaid
NE47052851514Medicaid
NE10025207900Medicaid
NE47052851513Medicaid