Provider Demographics
NPI:1346087202
Name:SANER, TIMOTHY LOUIS (PRACTICAL NURSE)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:LOUIS
Last Name:SANER
Suffix:
Gender:M
Credentials:PRACTICAL NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2206 LONGO DR STE 102
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68005-2977
Mailing Address - Country:US
Mailing Address - Phone:402-591-4500
Mailing Address - Fax:402-933-2825
Practice Address - Street 1:4101 WOOLWORTH AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68105-1850
Practice Address - Country:US
Practice Address - Phone:402-591-4500
Practice Address - Fax:402-933-2825
Is Sole Proprietor?:No
Enumeration Date:2024-07-09
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAP43277164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse