Healthcare Provider Details

I. General information

NPI: 1578092250
Provider Name (Legal Business Name): CASEY COLLINS HARRIS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2017
Last Update Date: 10/25/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 HOSPITAL DR STE 3B
COLUMBUS NC
28722-8516
US

IV. Provider business mailing address

PO BOX 1869
FLETCHER NC
28732-1869
US

V. Phone/Fax

Practice location:
  • Phone: 828-894-3230
  • Fax: 828-894-2568
Mailing address:
  • Phone: 828-687-5698
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5019753
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5019753
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: