Healthcare Provider Details

I. General information

NPI: 1821472119
Provider Name (Legal Business Name): JULIE HARRIS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2015
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 SOUTH ST STE 100
MOUNTAIN HOME AR
72653-4452
US

IV. Provider business mailing address

PO BOX 602
MABELVALE AR
72103-0602
US

V. Phone/Fax

Practice location:
  • Phone: 501-349-8835
  • Fax: 501-476-4404
Mailing address:
  • Phone: 501-349-8835
  • Fax: 501-476-4404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number227713
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: