Provider Demographics
NPI:1235936980
Name:AMAYA, TANIA
Entity type:Individual
Prefix:
First Name:TANIA
Middle Name:
Last Name:AMAYA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 WINTERS AVE
Mailing Address - Street 2:
Mailing Address - City:GLENVIL
Mailing Address - State:NE
Mailing Address - Zip Code:68941-2771
Mailing Address - Country:US
Mailing Address - Phone:402-705-8587
Mailing Address - Fax:
Practice Address - Street 1:2727 W 2ND ST
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-4684
Practice Address - Country:US
Practice Address - Phone:402-334-6900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-28
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant