Provider Demographics
NPI:1063226686
Name:HANSEN, LINDA DIANNE
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:DIANNE
Last Name:HANSEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7544 GERTRUDE ST APT 326
Mailing Address - Street 2:
Mailing Address - City:LA VISTA
Mailing Address - State:NE
Mailing Address - Zip Code:68128-2275
Mailing Address - Country:US
Mailing Address - Phone:402-750-7429
Mailing Address - Fax:
Practice Address - Street 1:5013 LAFAYETTE AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68132-1463
Practice Address - Country:US
Practice Address - Phone:402-658-6659
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care