MEDICARE: HANNAH BERAN D.C.

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	111N00000X	Chiropractor	1894	NE

General Provider Information

NPI Number	:	1710332234
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANNAH BERAN D.C.

Provider Business Mailing Address
First Line	:	11404 W DODGE RD STE 300
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68154-2511
Country	:	US
Telephone Number	:	402-915-4029
Fax Number	:

Provider Business Practice Location Address
First Line	:	11404 W DODGE RD STE 300
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68154-2511
Country	:	US
Telephone Number	:	402-919-4029
Fax Number	:

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

Provider Enumeration Date	:	05/03/2016
Last Update Date	:	04/06/2022

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