Active NPI
Tracy R Harrison, PAC
- Community Health/Public Health Clinical Nurse Specialist
- Omaha, NE
National Provider Identifier
1699784066
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health/Public Health Clinical Nurse Specialist
- License
- 1155
- Practice address
- 2915 Grant Street
Omaha, NE 68111 - Phone
- (402) 453-1433
- Fax
- (402) 453-2061
- NPI assigned
- Aug 5, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health/Public Health Clinical Nurse Specialist | 364SC1501X | 1155 | NE | Primary |
Addresses
Primary practice location
2915 Grant Street
Omaha, NE 68111
Mailing address
PO Box 300019
2915 Grant Street
Omaha, NE 68111
Phone (402) 457-1200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1155 | NE | MD | Dermatopathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1699784066",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 300019",
"address_2": "2915 GRANT STREET",
"city": "OMAHA",
"state": "NE",
"postal_code": "68111",
"telephone_number": "402-457-1200",
"fax_number": "402-453-1970"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2915 GRANT STREET",
"city": "OMAHA",
"state": "NE",
"postal_code": "68111",
"telephone_number": "402-453-1433",
"fax_number": "402-453-2061"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRISON",
"first_name": "TRACY",
"middle_name": "R",
"name_prefix": "Ms.",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "364SC1501X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist, Community Health/Public Health",
"state": "NE",
"license": "1155",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.