Van Winkle, Jerry Alan
Van Winkle, Jerry Alan is an sole proprietor health care provider with primary practice located at 2315 W 39Th St , Kearney NE 68845-8327. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Van Winkle, Jerry Alan can be contacted via phone (308) 224-4664.Contact Information
Primary practice address
2315 W 39Th St
Kearney NE 68845-8327
Phone: (308) 224-4664
Fax: (308) 237-5581
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 577 | Nebraska |
Profile Details
| NPI number | 1124115043 |
|---|---|
| LBN Legal business name | Van Winkle, Jerry Alan |
| Credentials | PSY.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 10th, 2006 |
| Last updated | Sep 7th, 2016 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124115043 | NPPES |
| Nebraska | MEDICAID | 10025728500 |
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