Provider Demographics
NPI:1952381915
Name:MEIDLINGER, JOHN CHARLES (PHD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:CHARLES
Last Name:MEIDLINGER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 N PINE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68801
Mailing Address - Country:US
Mailing Address - Phone:308-384-9594
Mailing Address - Fax:308-384-0446
Practice Address - Street 1:207 N PINE
Practice Address - Street 2:SUITE 100
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68801
Practice Address - Country:US
Practice Address - Phone:308-384-9594
Practice Address - Fax:308-384-0446
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2015-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE195103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47074664300Medicaid
NE08100OtherBLUE CROSS
NE5047OtherMIDLANDS CHOICE
NE08100OtherBLUE CROSS