Healthcare Provider Details

I. General information

NPI: 1780400333
Provider Name (Legal Business Name): RENE F SYKES PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/27/2024
Last Update Date: 11/27/2024
Certification Date: 11/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3615 2ND AVE STE A
KEARNEY NE
68847-8115
US

IV. Provider business mailing address

5523 PARKLANE DR
KEARNEY NE
68847-8606
US

V. Phone/Fax

Practice location:
  • Phone: 308-233-3847
  • Fax:
Mailing address:
  • Phone: 308-708-3303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number115720
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: