Provider Demographics
NPI:1265943088
Name:HERMANDSON, TIANNA MARIE (BSN)
Entity type:Individual
Prefix:MRS
First Name:TIANNA
Middle Name:MARIE
Last Name:HERMANDSON
Suffix:
Gender:F
Credentials:BSN
Other - Prefix:MS
Other - First Name:TIANNA
Other - Middle Name:MARIE
Other - Last Name:COLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSN
Mailing Address - Street 1:1299 FARNAM ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68102-1880
Mailing Address - Country:US
Mailing Address - Phone:402-401-2809
Mailing Address - Fax:
Practice Address - Street 1:1299 FARNAM ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68102-1880
Practice Address - Country:US
Practice Address - Phone:402-401-2809
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-19
Last Update Date:2017-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE66740163WR0400X, 163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care
No163WR0400XNursing Service ProvidersRegistered NurseRehabilitation