Provider Demographics
NPI:1053116210
Name:HAKE, BRENDA JEAN
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:JEAN
Last Name:HAKE
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 1:4181 B RD
Mailing Address - Street 2:
Mailing Address - City:BELLWOOD
Mailing Address - State:NE
Mailing Address - Zip Code:68624-2499
Mailing Address - Country:US
Mailing Address - Phone:402-270-6153
Mailing Address - Fax:
Practice Address - Street 1:4181 B RD
Practice Address - Street 2:
Practice Address - City:BELLWOOD
Practice Address - State:NE
Practice Address - Zip Code:68624-2499
Practice Address - Country:US
Practice Address - Phone:402-270-6153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-13
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE372500000X, 3747P1801X, 372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
No372500000XNursing Service Related ProvidersChore ProviderGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty