Healthcare Provider Details

I. General information

NPI: 1407427461
Provider Name (Legal Business Name): TRESA HARRIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2021
Last Update Date: 07/11/2025
Certification Date: 07/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2227 HAGERTY RD APT 1
LAS CRUCES NM
88001-5546
US

IV. Provider business mailing address

2227 HAGERTY RD APT 1
LAS CRUCES NM
88001-5546
US

V. Phone/Fax

Practice location:
  • Phone: 575-640-6083
  • Fax:
Mailing address:
  • Phone: 575-640-6083
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: