Provider Demographics
NPI:1760282719
Name:HARRIS, PAULINE VANESA
Entity type:Individual
Prefix:
First Name:PAULINE
Middle Name:VANESA
Last Name:HARRIS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:PAULINE
Other - Middle Name:VANESA
Other - Last Name:DANIELS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7905 L ST
Mailing Address - Street 2:STE 420
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68127
Mailing Address - Country:US
Mailing Address - Phone:402-515-2654
Mailing Address - Fax:531-242-4420
Practice Address - Street 1:7905 L ST
Practice Address - Street 2:STE 420
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68127
Practice Address - Country:US
Practice Address - Phone:402-515-2654
Practice Address - Fax:531-242-4420
Is Sole Proprietor?:No
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant