Healthcare Provider Details

I. General information

NPI: 1396672341
Provider Name (Legal Business Name): JONTE NICOLE HARRIS CNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

412 PIERCE ST
SIOUX CITY IA
51101-1414
US

IV. Provider business mailing address

2738 GLEN ELLEN RD
SIOUX CITY IA
51106-7123
US

V. Phone/Fax

Practice location:
  • Phone: 763-325-3179
  • Fax:
Mailing address:
  • Phone: 763-325-3179
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: