Healthcare Provider Details

I. General information

NPI: 1043147390
Provider Name (Legal Business Name): ANGEL RENA HERNANDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BRANI JANE HEMMINGSEN NHA

II. Dates (important events)

Enumeration Date: 05/08/2026
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 N 10TH AVE
BROKEN BOW NE
68822-1505
US

IV. Provider business mailing address

333 N 10TH AVE
BROKEN BOW NE
68822-1505
US

V. Phone/Fax

Practice location:
  • Phone: 308-249-5276
  • Fax: 308-249-5276
Mailing address:
  • Phone: 308-249-5276
  • Fax: 308-249-5276

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number102374
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: