Provider Demographics
NPI:1235938960
Name:HARRIS, NATALYA
Entity type:Individual
Prefix:
First Name:NATALYA
Middle Name:
Last Name:HARRIS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13615 POLK PLZ APT 711
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68137-4182
Mailing Address - Country:US
Mailing Address - Phone:531-210-8671
Mailing Address - Fax:
Practice Address - Street 1:13615 POLK PLZ APT 711
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-4182
Practice Address - Country:US
Practice Address - Phone:531-210-8671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant