Healthcare Provider Details

I. General information

NPI: 1164319828
Provider Name (Legal Business Name): NOOR HASSAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2025
Last Update Date: 06/23/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5027 A ST
OMAHA NE
68106-4443
US

IV. Provider business mailing address

5027 A ST
OMAHA NE
68106-4443
US

V. Phone/Fax

Practice location:
  • Phone: 531-262-9189
  • Fax: 531-262-9189
Mailing address:
  • Phone: 531-262-9189
  • Fax: 531-262-9189

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: