Healthcare Provider Details

I. General information

NPI: 1659201366
Provider Name (Legal Business Name): FARHIYO NUR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1805 N 73RD ST
OMAHA NE
68114-1905
US

IV. Provider business mailing address

2517 CALDWELL ST APT 241
OMAHA NE
68131-4602
US

V. Phone/Fax

Practice location:
  • Phone: 402-557-8583
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: