Provider Demographics
NPI:1902618119
Name:PINKNEY, SHANA MARIE
Entity type:Individual
Prefix:
First Name:SHANA
Middle Name:MARIE
Last Name:PINKNEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1714 S 26TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68105-2619
Mailing Address - Country:US
Mailing Address - Phone:531-283-3992
Mailing Address - Fax:
Practice Address - Street 1:2500 B ST APT 202
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68105-4040
Practice Address - Country:US
Practice Address - Phone:402-810-4539
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-23
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE372500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372500000XNursing Service Related ProvidersChore ProviderGroup - Single Specialty