Healthcare Provider Details

I. General information

NPI: 1366582942
Provider Name (Legal Business Name): CHRISTA JANEL HARRISON RN, CNOR, RNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHRIS HARRISON RNFA

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 08/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9408 INDIAN PIPE LN
PROSPECT KY
40059-7000
US

IV. Provider business mailing address

9408 INDIAN PIPE LN
PROSPECT KY
40059-7000
US

V. Phone/Fax

Practice location:
  • Phone: 502-713-9020
  • Fax:
Mailing address:
  • Phone: 502-713-9020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number1068568
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: