Healthcare Provider Details

I. General information

NPI: 1144065566
Provider Name (Legal Business Name): FAITH HARRIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2024
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 ERWIN RD
DURHAM NC
27705-4699
US

IV. Provider business mailing address

206 ROYAL OAK DR
GUYTON GA
31312-5627
US

V. Phone/Fax

Practice location:
  • Phone: 912-401-1337
  • Fax:
Mailing address:
  • Phone: 912-401-1337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: