Healthcare Provider Details

I. General information

NPI: 1902848138
Provider Name (Legal Business Name): SHARON EILEEN J HARRIS APRN, BC
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1014 MAIN ST
ELGIN IA
52141-9616
US

IV. Provider business mailing address

PO BOX 113
CLERMONT IA
52135-0113
US

V. Phone/Fax

Practice location:
  • Phone: 563-426-5136
  • Fax: 563-426-5139
Mailing address:
  • Phone: 563-423-5557
  • Fax: 563-423-5557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA-112377
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: