Tynetha Latrice Hazley
Technician, Personal Care Attendant in Omaha, NE. Individual provider (NPI-1).
NPI number1093661886
StatusActive
Last updated in NPPESMar 5, 2026
Details
- NPI
- 1093661886
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Tynetha Latrice Hazley
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Mar 5, 2026
- Certification date
- Mar 5, 2026
- Last updated
- Mar 5, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3747P1801X | Technician, Personal Care Attendant | – | – | Yes |
Practice location
10306 Ellison CirOmaha, NE 68134-1024
Phone 402-707-7995
Mailing address
6701 N 107th PlzOmaha, NE 68122-3042
Phone 402-707-7995
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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