Healthcare Provider Details

I. General information

NPI: 1437061488
Provider Name (Legal Business Name): HANA D TUT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11522 WESTWOOD LN
OMAHA NE
68144-4371
US

IV. Provider business mailing address

11522 WESTWOOD LN APT 19
OMAHA NE
68144-4360
US

V. Phone/Fax

Practice location:
  • Phone: 402-953-3985
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: