Healthcare Provider Details

I. General information

NPI: 1457275331
Provider Name (Legal Business Name): SEBRINA HARRIS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2420 WINDSOR SPRING RD
AUGUSTA GA
30906-4668
US

IV. Provider business mailing address

986 OLD LOUISVILLE RD
HARLEM GA
30814-4302
US

V. Phone/Fax

Practice location:
  • Phone: 706-790-0661
  • Fax:
Mailing address:
  • Phone: 706-830-7093
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN177973
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: