Healthcare Provider Details

I. General information

NPI: 1336360684
Provider Name (Legal Business Name): MRS. JOAN M. YEKEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 08/27/2024
Certification Date: 08/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 W 3RD ST
CHADRON NE
69337-2314
US

IV. Provider business mailing address

PO BOX 1299
CHADRON NE
69337-1299
US

V. Phone/Fax

Practice location:
  • Phone: 308-430-4610
  • Fax: 308-747-2147
Mailing address:
  • Phone: 308-430-4610
  • Fax: 308-747-2147

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1700
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: