Healthcare Provider Details

I. General information

NPI: 1528482809
Provider Name (Legal Business Name): BRITTANY HARRIS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2014
Last Update Date: 02/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 PHYSICIANS DR
JACKSON TN
38305-2071
US

IV. Provider business mailing address

9 PHYSICIANS DR
JACKSON TN
38305-2071
US

V. Phone/Fax

Practice location:
  • Phone: 731-661-0086
  • Fax: 731-661-0281
Mailing address:
  • Phone: 731-661-0086
  • Fax: 731-661-0281

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number173831
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number18421
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: