MEDICARE: TAMALA R HOUSER-HANSON APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	111080	NE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	111080	OTHER	NE	NE APRN LICENSE
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427389816
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMALA R HOUSER-HANSON APRN

Provider Business Mailing Address
First Line	:	PO BOX 2797
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68103-2797
Country	:	US
Telephone Number	:	402-354-4230
Fax Number	:	402-354-6171

Provider Business Practice Location Address
First Line	:	515 N 162ND AVE STE 301
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68118-2540
Country	:	US
Telephone Number	:	402-354-7320
Fax Number	:	402-354-7325

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/25/2010
Last Update Date	:	03/06/2018

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Directions to “ TAMALA R HOUSER-HANSON APRN” Practice Location

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