MEDICARE: KAMESHA HARRIS LPN

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
1	164W00000X	Licensed Practical Nurse	48516	SC

General Provider Information

NPI Number	:	1770453326
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAMESHA HARRIS LPN

Provider Business Mailing Address
First Line	:	155 RED GLOBE LN
Second Line	:
City	:	WOODRUFF
State	:	SC
Zip	:	29388-9749
Country	:	US
Telephone Number	:	864-356-4487
Fax Number	:

Provider Business Practice Location Address
First Line	:	155 RED GLOBE LN
Second Line	:
City	:	WOODRUFF
State	:	SC
Zip	:	29388-9749
Country	:	US
Telephone Number	:	864-356-4487
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/10/2025
Last Update Date	:	11/10/2025

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