Provider Demographics
NPI:1962570390
Name:KEARNEY, TINA CHRISTINE (MD)
Entity type:Individual
Prefix:DR
First Name:TINA
Middle Name:CHRISTINE
Last Name:KEARNEY
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Gender:F
Credentials:MD
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Mailing Address - Street 1:4600 VALLEY ROAD
Mailing Address - Street 2:STE 200
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-4882
Mailing Address - Country:US
Mailing Address - Phone:402-483-4571
Mailing Address - Fax:402-483-5633
Practice Address - Street 1:4600 VALLEY ROAD
Practice Address - Street 2:STE 200
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-4882
Practice Address - Country:US
Practice Address - Phone:402-483-4571
Practice Address - Fax:402-483-5633
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2021-04-21
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Provider Licenses
StateLicense IDTaxonomies
NE29074207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE470553011-00Medicaid
NE9277600010Medicare PIN