Healthcare Provider Details

I. General information

NPI: 1205775178
Provider Name (Legal Business Name): KIERSTEN N HANSEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3219 CENTRAL AVE STE 103
KEARNEY NE
68847-2949
US

IV. Provider business mailing address

76760 ROAD 416
GOTHENBURG NE
69138-3421
US

V. Phone/Fax

Practice location:
  • Phone: 402-982-3972
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: