Provider Demographics
NPI:1871882167
Name:HUTZEL, TIFFANY J (RN)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:J
Last Name:HUTZEL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:J
Other - Last Name:SAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5420 UNION HILL ROAD
Mailing Address - Street 2:#902
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-6524
Mailing Address - Country:US
Mailing Address - Phone:402-304-0027
Mailing Address - Fax:
Practice Address - Street 1:5420 UNION HILL RD
Practice Address - Street 2:#902
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-6524
Practice Address - Country:US
Practice Address - Phone:402-304-0027
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-07
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE55691163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse