Healthcare Provider Details

I. General information

NPI: 1104506872
Provider Name (Legal Business Name): ANGELA CAYE HARRIS APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2023
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10810 FARNAM DR STE 110
OMAHA NE
68154-3257
US

IV. Provider business mailing address

10810 FARNAM DR STE 110
OMAHA NE
68154-3257
US

V. Phone/Fax

Practice location:
  • Phone: 531-484-3155
  • Fax: 833-907-2284
Mailing address:
  • Phone: 531-484-3155
  • Fax: 833-907-2284

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number114613
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number114613
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: