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NPI Code Detail

MEDICARE: MRS. CONNIE LINNETTE HARRIS

MEDICARE: MRS. CONNIE LINNETTE HARRIS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1252Y00000XEarly Intervention Provider Agency
23747P1801XPersonal Care Attendant
3251S00000XCommunity/Behavioral Health Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1205222924
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CONNIE LINNETTE HARRIS
Provider Business Mailing Address
First Line : 1264 MOON VISION ST
Second Line :
City : HENDERSON
State : NV
Zip : 89052
Country : US
Telephone Number : 701-491-1265
Fax Number : 702-453-8874
Provider Business Practice Location Address
First Line : 1380 E SILVERADO RANCH BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89183-5924
Country : US
Telephone Number : 702-491-1265
Fax Number : 702-453-8874
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2015
Last Update Date : 03/28/2022

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Directions to “ MRS. CONNIE LINNETTE HARRIS ” Practice Location

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