MEDICARE: BRENNAN T HALE

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	374700000X	Technician		NE

General Provider Information

NPI Number	:	1518849751
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENNAN T HALE

Provider Business Mailing Address
First Line	:	3775 CURTIS AVE
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68111-1169
Country	:	US
Telephone Number	:	402-278-4334
Fax Number	:

Provider Business Practice Location Address
First Line	:	4424 MANCHESTER DR
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68112-1360
Country	:	US
Telephone Number	:	402-278-4334
Fax Number	:	402-278-4334

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

Provider Enumeration Date	:	07/21/2025
Last Update Date	:	07/21/2025

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Directions to “ BRENNAN T HALE ” Practice Location

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