Healthcare Provider Details

I. General information

NPI: 1174455851
Provider Name (Legal Business Name): DARYA JANAE HARRIS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DARYA JANAE MCKENZIE

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3888 HIGHWAY 90
PACE FL
32571-1014
US

IV. Provider business mailing address

3888 HIGHWAY 90
PACE FL
32571-1014
US

V. Phone/Fax

Practice location:
  • Phone: 850-994-2229
  • Fax: 850-994-7199
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11044458
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: