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General NPI Number Information
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NPI Number | 1831238088
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Entity Type | Individual
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Provider Name | NANCY A. PUCKETT LMHP, CPC
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Gender | Female
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 10/11/2011
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Provider Practice Location Address
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Address Line | 100 N 15TH ST
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City | ORD
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State | NE
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Zip | 68862-1458
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Country | US
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Telephone | 308-728-9979
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Fax | 308-728-9980
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Provider Business Mailing Address
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Address Line | PO BOX 226
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City | ORD
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State | NE
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Zip | 68862-0226
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Country | US
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Telephone | 308-728-9979
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Fax | 308-728-9980
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 2947
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License Number State | NE
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