MEDICARE: HALEY DITTMER

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	172V00000X	Community Health Worker

General Provider Information

NPI Number	:	1497603146
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HALEY DITTMER

Provider Business Mailing Address
First Line	:	7929 W CENTER RD
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68124-3104
Country	:	US
Telephone Number	:	402-441-7940
Fax Number	:	402-441-8491

Provider Business Practice Location Address
First Line	:	2301 O ST
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68510-1124
Country	:	US
Telephone Number	:	402-441-7940
Fax Number	:	402-441-8491

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

Provider Enumeration Date	:	03/18/2026
Last Update Date	:	03/18/2026

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Directions to “ HALEY DITTMER ” Practice Location

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