Provider Demographics
NPI:1174762405
Name:OLANDER, REBECCA KAY (PMHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:KAY
Last Name:OLANDER
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:MS
Other - First Name:REBECCA
Other - Middle Name:KAY
Other - Last Name:TIELKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5539 SOUTH 27TH ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68512-1648
Mailing Address - Country:US
Mailing Address - Phone:402-261-6212
Mailing Address - Fax:402-817-4949
Practice Address - Street 1:5539 SOUTH 27TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68512-1648
Practice Address - Country:US
Practice Address - Phone:402-261-6212
Practice Address - Fax:402-817-4949
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-10
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE111229363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47070592313Medicaid