Provider Demographics
NPI:1114725694
Name:HARRIS, DERBIE K
Entity type:Individual
Prefix:
First Name:DERBIE
Middle Name:K
Last Name:HARRIS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3444 N 105TH PLZ APT 1620
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68134-3620
Mailing Address - Country:US
Mailing Address - Phone:402-937-3949
Mailing Address - Fax:
Practice Address - Street 1:3444 N 105TH PLZ APT 1620
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68134-3620
Practice Address - Country:US
Practice Address - Phone:402-937-3949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care