Provider Demographics
NPI:1487450961
Name:HAENEL, DARLENE MARIE
Entity type:Individual
Prefix:MRS
First Name:DARLENE
Middle Name:MARIE
Last Name:HAENEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DARLENE
Other - Middle Name:MARIE
Other - Last Name:O'CONNOR MCINTOSH GAYLORD GERHART H
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8134 BEAR LAKE RD
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:NY
Mailing Address - Zip Code:14784
Mailing Address - Country:US
Mailing Address - Phone:573-480-6437
Mailing Address - Fax:
Practice Address - Street 1:1820 HILLCREST DRIVE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68005
Practice Address - Country:US
Practice Address - Phone:402-682-6599
Practice Address - Fax:402-682-6563
Is Sole Proprietor?:No
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant