Healthcare Provider Details

I. General information

NPI: 1053695726
Provider Name (Legal Business Name): MEGAN MICHELLE GEWECKE PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEGAN MICHELLE JONES PSY.D.

II. Dates (important events)

Enumeration Date: 09/29/2011
Last Update Date: 08/25/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2804 2ND AVE
KEARNEY NE
68847-3500
US

IV. Provider business mailing address

2804 2ND AVENUE
KEARNEY NE
68847
US

V. Phone/Fax

Practice location:
  • Phone: 308-455-8605
  • Fax: 308-455-8606
Mailing address:
  • Phone: 308-455-8605
  • Fax: 308-455-8606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: