Healthcare Provider Details

I. General information

NPI: 1467260174
Provider Name (Legal Business Name): DIANA MICHELLE COMPTON-REAVES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2024
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 N. 127 ST.
OMAHA NE
68154
US

IV. Provider business mailing address

13521 WASHINGTON CIR
OMAHA NE
68137-4245
US

V. Phone/Fax

Practice location:
  • Phone: 531-299-2341
  • Fax:
Mailing address:
  • Phone: 531-232-6674
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374700000X
TaxonomyTechnician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: