Healthcare Provider Details

I. General information

NPI: 1558226175
Provider Name (Legal Business Name): SHAREEKA HARRIS
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 SLEEPY HOLLOW RD
MARSHALLVILLE GA
31057-9628
US

IV. Provider business mailing address

310 SLEEPY HOLLOW RD
MARSHALLVILLE GA
31057-9628
US

V. Phone/Fax

Practice location:
  • Phone: 561-644-2017
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberRN317896
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: