1699249813 NPI number — HEATHER RANKIN LMHP

Table of content: HEATHER RANKIN LMHP (NPI 1699249813)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699249813 NPI number — HEATHER RANKIN LMHP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RANKIN
Provider First Name:
HEATHER
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LMHP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SKILLSTAD
Provider Other First Name:
HEATHER
Provider Other Middle Name:
K
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1699249813
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/25/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2608 OLD FAIR RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GRAND ISLAND
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68803-5271
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
308-382-5297
Provider Business Mailing Address Fax Number:
308-382-5315

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
414 W MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALBION
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68620-1231
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
308-382-5297
Provider Business Practice Location Address Fax Number:
308-382-5315
Provider Enumeration Date:
01/22/2019

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  6223 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)