Provider Demographics
NPI:1356239859
Name:BERLEUE, TIANNA
Entity type:Individual
Prefix:MS
First Name:TIANNA
Middle Name:
Last Name:BERLEUE
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:TIANNA
Other - Middle Name:
Other - Last Name:NELSEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2704 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68845-4326
Mailing Address - Country:US
Mailing Address - Phone:308-293-5818
Mailing Address - Fax:
Practice Address - Street 1:14301 FNB PKWY STE 100
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-7200
Practice Address - Country:US
Practice Address - Phone:402-807-7447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-25
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician