Provider Demographics
NPI:1487732319
Name:HRUBY, KRISTINE (LIMHP, LADC)
Entity type:Individual
Prefix:MRS
First Name:KRISTINE
Middle Name:
Last Name:HRUBY
Suffix:
Gender:F
Credentials:LIMHP, LADC
Other - Prefix:
Other - First Name:KRISTY
Other - Middle Name:
Other - Last Name:HRUBY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LIMHP, LADC
Mailing Address - Street 1:1811 W 2ND ST STE 450
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-5473
Mailing Address - Country:US
Mailing Address - Phone:308-390-5508
Mailing Address - Fax:308-339-0962
Practice Address - Street 1:1811 W 2ND ST STE 450
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-5473
Practice Address - Country:US
Practice Address - Phone:308-390-5508
Practice Address - Fax:308-339-0962
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE404101YA0400X
NE8548101YM0800X
101YM0800X
NE2182101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47077707526Medicaid