Provider Demographics
NPI:1730992082
Name:HERRERA, JOE ROBERT
Entity type:Individual
Prefix:
First Name:JOE
Middle Name:ROBERT
Last Name:HERRERA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 PLATTE AVE
Mailing Address - Street 2:
Mailing Address - City:ALLIANCE
Mailing Address - State:NE
Mailing Address - Zip Code:69301-3266
Mailing Address - Country:US
Mailing Address - Phone:308-760-5199
Mailing Address - Fax:
Practice Address - Street 1:319 BLACK HILLS AVE
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:NE
Practice Address - Zip Code:69301-3209
Practice Address - Country:US
Practice Address - Phone:308-762-1970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-30
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker