Provider Demographics
NPI:1639976061
Name:HINES, TIERRA D
Entity type:Individual
Prefix:MRS
First Name:TIERRA
Middle Name:D
Last Name:HINES
Suffix:
Gender:
Credentials:
Other - Prefix:MISS
Other - First Name:TIERRA
Other - Middle Name:D
Other - Last Name:SELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2227 S 50TH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-2015
Mailing Address - Country:US
Mailing Address - Phone:402-264-7404
Mailing Address - Fax:
Practice Address - Street 1:1035 GOODHUE BLVD
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68508-4341
Practice Address - Country:US
Practice Address - Phone:402-264-7404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-25
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
253Z00000X
NE372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No253Z00000XAgenciesIn Home Supportive Care