Healthcare Provider Details

I. General information

NPI: 1578597944
Provider Name (Legal Business Name): DORENE ANITA HARRISON MSN, FNP,CRNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 01/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3599 W HILLSBORO BLVD
DEERFIELD BEACH FL
33442-9404
US

IV. Provider business mailing address

110 NIGHTHAWK AVE
PLANTATION FL
33324-2178
US

V. Phone/Fax

Practice location:
  • Phone: 954-333-5214
  • Fax:
Mailing address:
  • Phone: 702-340-4463
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9322648
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: