Healthcare Provider Details

I. General information

NPI: 1255163002
Provider Name (Legal Business Name): RACHELE HIEBERT OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RACHELE HEATON

II. Dates (important events)

Enumeration Date: 08/19/2024
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8701 S 100TH ST
LA VISTA NE
68128-3078
US

IV. Provider business mailing address

8701 S 100TH ST
LA VISTA NE
68128-3078
US

V. Phone/Fax

Practice location:
  • Phone: 402-708-4591
  • Fax:
Mailing address:
  • Phone: 402-708-4591
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number2928
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: