Healthcare Provider Details

I. General information

NPI: 1922968742
Provider Name (Legal Business Name): CAROL ANN ELIZABETH HARP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2025
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3014 E BUSINESS 190
COPPERAS COVE TX
76522-2504
US

IV. Provider business mailing address

156 NORRIS HANCOCK RD
BIG ROCK TN
37023-3041
US

V. Phone/Fax

Practice location:
  • Phone: 254-577-4384
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1228348
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number223658
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1228348
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: