Provider Demographics
NPI:1902787039
Name:HITTNER, HALEY ROSE (MS,RDN,LMNT)
Entity type:Individual
Prefix:MRS
First Name:HALEY
Middle Name:ROSE
Last Name:HITTNER
Suffix:
Gender:F
Credentials:MS,RDN,LMNT
Other - Prefix:MISS
Other - First Name:HALEY
Other - Middle Name:ROSE
Other - Last Name:THIELE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS,RDN, LMNT
Mailing Address - Street 1:1760 COUNTY ROAD J
Mailing Address - Street 2:
Mailing Address - City:WAHOO
Mailing Address - State:NE
Mailing Address - Zip Code:68066-4152
Mailing Address - Country:US
Mailing Address - Phone:402-443-4191
Mailing Address - Fax:402-443-1402
Practice Address - Street 1:1760 COUNTY ROAD J
Practice Address - Street 2:
Practice Address - City:WAHOO
Practice Address - State:NE
Practice Address - Zip Code:68066-4152
Practice Address - Country:US
Practice Address - Phone:402-443-4191
Practice Address - Fax:402-443-1402
Is Sole Proprietor?:No
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1706133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered