Provider Demographics
NPI:1023586781
Name:HANSMAN, HEATHER ASHLEY
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:ASHLEY
Last Name:HANSMAN
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 1:7561 MAIN ST STE 402
Mailing Address - Street 2:
Mailing Address - City:RALSTON
Mailing Address - State:NE
Mailing Address - Zip Code:68127-3993
Mailing Address - Country:US
Mailing Address - Phone:402-699-9188
Mailing Address - Fax:402-339-7955
Practice Address - Street 1:7561 MAIN ST STE 402
Practice Address - Street 2:
Practice Address - City:RALSTON
Practice Address - State:NE
Practice Address - Zip Code:68127-3993
Practice Address - Country:US
Practice Address - Phone:402-699-9188
Practice Address - Fax:402-339-7955
Is Sole Proprietor?:No
Enumeration Date:2018-11-10
Last Update Date:2018-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3303225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist