Healthcare Provider Details

I. General information

NPI: 1528997939
Provider Name (Legal Business Name): TIFFANY KAY BRAND RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 S 18TH PLZ
OMAHA NE
68102-2077
US

IV. Provider business mailing address

4101 WOOLWORTH AVE
OMAHA NE
68105-1850
US

V. Phone/Fax

Practice location:
  • Phone: 402-996-3539
  • Fax:
Mailing address:
  • Phone: 402-996-3539
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number094816
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: