Provider Demographics
NPI:1326853052
Name:DOUGHERTY HELLEBERG, JOSH
Entity type:Individual
Prefix:
First Name:JOSH
Middle Name:
Last Name:DOUGHERTY HELLEBERG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3106 12TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68845-3337
Mailing Address - Country:US
Mailing Address - Phone:308-293-4286
Mailing Address - Fax:
Practice Address - Street 1:3106 12TH AVENUE
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68845-3337
Practice Address - Country:US
Practice Address - Phone:308-293-4286
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion