Provider Demographics
NPI:1912451063
Name:HERRERA, NANCY
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:HERRERA
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 1:1103 TANGLEWOOD CT APT 99
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68005-4778
Mailing Address - Country:US
Mailing Address - Phone:402-906-3277
Mailing Address - Fax:402-513-7731
Practice Address - Street 1:1103 TANGLEWOOD CT APT 99
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68005-4778
Practice Address - Country:US
Practice Address - Phone:402-906-3277
Practice Address - Fax:402-513-7731
Is Sole Proprietor?:No
Enumeration Date:2016-08-06
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE10911101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health