Healthcare Provider Details

I. General information

NPI: 1437054467
Provider Name (Legal Business Name): DAJUA LAREE LIGGINS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4331 N 55AVE
OMAHA NE
68104
US

IV. Provider business mailing address

4331 N 55TH AVE
OMAHA NE
68104-2829
US

V. Phone/Fax

Practice location:
  • Phone: 402-214-7853
  • Fax:
Mailing address:
  • Phone: 402-214-7853
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0002X
TaxonomyHigh-Risk Obstetric Registered Nurse
License NumberH13606432
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: