Healthcare Provider Details

I. General information

NPI: 1477317758
Provider Name (Legal Business Name): ANNA HARRIS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2024
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8529 N DIXIE DR
DAYTON OH
45414-2400
US

IV. Provider business mailing address

6661 HARSHMANVILLE RD
HUBER HEIGHTS OH
45424-3518
US

V. Phone/Fax

Practice location:
  • Phone: 937-417-8921
  • Fax:
Mailing address:
  • Phone: 937-524-6418
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0035810
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: