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NPI Code Detail

MEDICARE: NICOLE HARRIS RN, BSN

MEDICARE:   NICOLE  HARRIS  RN, BSN
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
1163W00000XRegistered NurseRN241406GA

General Provider Information

NPI Number : 1902751126
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE HARRIS RN, BSN
Provider Business Mailing Address
First Line : 508 VAN BUREN RD
Second Line :
City : BARNESVILLE
State : GA
Zip : 30204-3152
Country : US
Telephone Number : 678-794-9071
Fax Number :
Provider Business Practice Location Address
First Line : 1007 MEMORIAL DR
Second Line :
City : GRIFFIN
State : GA
Zip : 30223-4445
Country : US
Telephone Number : 770-467-4740
Fax Number : 770-467-4740
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2026
Last Update Date : 03/03/2026

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Directions to “ NICOLE HARRIS RN, BSN” Practice Location

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