Healthcare Provider Details

I. General information

NPI: 1659201895
Provider Name (Legal Business Name): DESIREE HARRIS NRP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12401 E 17TH AVE
AURORA CO
80045-2548
US

IV. Provider business mailing address

1180 S FENTON ST
LAKEWOOD CO
80232-5842
US

V. Phone/Fax

Practice location:
  • Phone: 970-210-0089
  • Fax:
Mailing address:
  • Phone: 970-210-0089
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License Number028239
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: