Healthcare Provider Details

I. General information

NPI: 1578113130
Provider Name (Legal Business Name): BARBARA K CLINKENBEARD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2019
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4308 VICTORIA AVENUE
BELLEVUE NE
68123
US

IV. Provider business mailing address

4308 VICTORIA AVE
BELLEVUE NE
68123-4183
US

V. Phone/Fax

Practice location:
  • Phone: 402-804-2015
  • Fax: 531-466-3101
Mailing address:
  • Phone: 402-804-2015
  • Fax: 531-466-3101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: BARBARA K CLINKENBEARD
Title or Position: PRESIDENT
Credential: APRN
Phone: 402-804-2015