Healthcare Provider Details

I. General information

NPI: 1235074055
Provider Name (Legal Business Name): BERNICE HARRIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: RITA HARRIS PARTNER

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1647 HOLBROOK ST NE APT 2
WASHINGTON DC
20002-2542
US

IV. Provider business mailing address

1647 HOLBROOK ST NE APT 2
WASHINGTON DC
20002-2542
US

V. Phone/Fax

Practice location:
  • Phone: 202-577-5884
  • Fax:
Mailing address:
  • Phone: 202-577-5884
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374T00000X
TaxonomyReligious Nonmedical Nursing Personnel
License Number
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: