Provider Demographics
NPI:1144298324
Name:JANKY, THOMAS L (CRNA)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:L
Last Name:JANKY
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:462 CHAPMAN RD
Mailing Address - Street 2:
Mailing Address - City:CHAPMAN
Mailing Address - State:NE
Mailing Address - Zip Code:68827-2736
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:462 CHAPMAN RD
Practice Address - Street 2:
Practice Address - City:CHAPMAN
Practice Address - State:NE
Practice Address - Zip Code:68827-2736
Practice Address - Country:US
Practice Address - Phone:308-986-2600
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE100663367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47081501000Medicaid
NE276960Medicare ID - Type Unspecified