Provider Demographics
NPI:1881418135
Name:HARKNESS, KELLI DIANNE (DNP, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:KELLI
Middle Name:DIANNE
Last Name:HARKNESS
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:KELLI
Other - Middle Name:DIANNE
Other - Last Name:ROYCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4239 FARNAM STREET
Mailing Address - Street 2:SUITE 100
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68131-2858
Mailing Address - Country:US
Mailing Address - Phone:402-522-2320
Mailing Address - Fax:402-552-2330
Practice Address - Street 1:4239 FARNAM STREET
Practice Address - Street 2:SUITE 100
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68131-2858
Practice Address - Country:US
Practice Address - Phone:402-522-2320
Practice Address - Fax:402-552-2330
Is Sole Proprietor?:No
Enumeration Date:2024-11-13
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA182191363L00000X
NE115692363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner