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General NPI Number Information
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NPI Number | 1427936988
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Entity Type | Individual
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Provider Name | KYLE JACOB HARBISON
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Gender | Male
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Dates
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Enumeration Date | 08/23/2025
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Last Update Date | 08/23/2025
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Provider Practice Location Address
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Address Line | 8303 DODGE ST
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City | OMAHA
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State | NE
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Zip | 68114-4199
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Country | US
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Telephone | 402-354-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 1301 S 52ND ST
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City | OMAHA
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State | NE
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Zip | 68106-2301
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Country | US
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Telephone | 402-595-0545
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | 89821
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License Number State | NE
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