Healthcare Provider Details

I. General information

NPI: 1669492898
Provider Name (Legal Business Name): JACQUELINE R HANKS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

982168 NEBRASKA MEDICAL CTR
OMAHA NE
68198-2168
US

IV. Provider business mailing address

982168 NEBRASKA MEDICAL CTR
OMAHA NE
68198-2168
US

V. Phone/Fax

Practice location:
  • Phone: 402-559-7749
  • Fax: 402-559-6762
Mailing address:
  • Phone: 402-559-7749
  • Fax: 402-559-6762

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number110686
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number110686
License Number StateNE
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number110686
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: