Provider Demographics
NPI:1063386118
Name:BONDS, BREAH TANAE
Entity type:Individual
Prefix:MS
First Name:BREAH
Middle Name:TANAE
Last Name:BONDS
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 1:11210 SEWARD PLZ APT 2208
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-4892
Mailing Address - Country:US
Mailing Address - Phone:402-906-1385
Mailing Address - Fax:
Practice Address - Street 1:3301 N 177TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68116-2281
Practice Address - Country:US
Practice Address - Phone:402-906-1385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-01
Last Update Date:2025-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEH143693773747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant