Healthcare Provider Details

I. General information

NPI: 1508286659
Provider Name (Legal Business Name): DONNA ECKLUND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DONNA HARDING

II. Dates (important events)

Enumeration Date: 04/16/2014
Last Update Date: 07/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 E 31ST ST
KEARNEY NE
68847
US

IV. Provider business mailing address

PO BOX 2583
KEARNEY NE
68848-2583
US

V. Phone/Fax

Practice location:
  • Phone: 308-234-6029
  • Fax: 308-237-4792
Mailing address:
  • Phone: 308-234-6029
  • Fax: 308-237-4792

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: