Provider Demographics
NPI:1164319554
Name:PHOE, HLA YIN
Entity type:Individual
Prefix:
First Name:HLA YIN
Middle Name:
Last Name:PHOE
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 1:4815 N 66TH ST APT 123
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68104-1936
Mailing Address - Country:US
Mailing Address - Phone:479-979-5457
Mailing Address - Fax:
Practice Address - Street 1:4815 N 66TH ST APT 123
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68104-1936
Practice Address - Country:US
Practice Address - Phone:479-979-5457
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-19
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant