Provider Demographics
NPI:1205411147
Name:NIEHAUS, REGAN (CSS)
Entity Type:Individual
Prefix:
First Name:REGAN
Middle Name:
Last Name:NIEHAUS
Suffix:
Gender:F
Credentials:CSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 S 24TH ST STE 230
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68102-1226
Mailing Address - Country:US
Mailing Address - Phone:402-978-5632
Mailing Address - Fax:
Practice Address - Street 1:120 S 24TH ST STE 100
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68102-1205
Practice Address - Country:US
Practice Address - Phone:402-342-7007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-12
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker