Provider Demographics
NPI:1194533679
Name:HELLER, REAGANNE ELIZABETH
Entity type:Individual
Prefix:
First Name:REAGANNE
Middle Name:ELIZABETH
Last Name:HELLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2535 N 64TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68104-4033
Mailing Address - Country:US
Mailing Address - Phone:402-699-2878
Mailing Address - Fax:
Practice Address - Street 1:4516 N 153RD CIR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68116-4376
Practice Address - Country:US
Practice Address - Phone:402-699-2878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No374U00000XNursing Service Related ProvidersHome Health Aide
No251E00000XAgenciesHome Health
No372600000XNursing Service Related ProvidersAdult Companion
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant