Provider Demographics
NPI:1730990284
Name:HYTCHE, TA'QUAYLA GOLDIE
Entity type:Individual
Prefix:
First Name:TA'QUAYLA
Middle Name:GOLDIE
Last Name:HYTCHE
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 1:3345 N 36TH AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68111-3104
Mailing Address - Country:US
Mailing Address - Phone:402-972-0249
Mailing Address - Fax:
Practice Address - Street 1:2011 N 25TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68111-4402
Practice Address - Country:US
Practice Address - Phone:402-972-0249
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide