Healthcare Provider Details

I. General information

NPI: 1922025790
Provider Name (Legal Business Name): KEVIN HARM APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2006
Last Update Date: 10/18/2023
Certification Date: 08/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3775 45TH AVE
COLUMBUS NE
68601-4427
US

IV. Provider business mailing address

4321 41ST AVE
COLUMBUS NE
68601-2131
US

V. Phone/Fax

Practice location:
  • Phone: 402-564-7200
  • Fax: 402-564-7210
Mailing address:
  • Phone: 402-562-7500
  • Fax: 402-564-0611

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number110386
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number110386
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: