Healthcare Provider Details

I. General information

NPI: 1306615703
Provider Name (Legal Business Name): BRITTANY AMBER HARRIS RN, CBS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2023
Last Update Date: 07/09/2024
Certification Date: 07/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3692 W MARKET ST
JOHNSON CITY TN
37604-9302
US

IV. Provider business mailing address

106 BEECHBROOK CT
UNICOI TN
37692-6441
US

V. Phone/Fax

Practice location:
  • Phone: 423-737-5794
  • Fax:
Mailing address:
  • Phone: 423-646-1703
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberRN0000182201
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: