Healthcare Provider Details

I. General information

NPI: 1467362632
Provider Name (Legal Business Name): KRISTIN ANN HARRIS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

159 BARNEGAT RD
POUGHKEEPSIE NY
12601-5401
US

IV. Provider business mailing address

239 VASSAR RD
POUGHKEEPSIE NY
12603-5720
US

V. Phone/Fax

Practice location:
  • Phone: 845-454-1942
  • Fax:
Mailing address:
  • Phone: 845-705-0091
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number312991
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: