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General NPI Number Information
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NPI Number | 1114401478
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Entity Type | Individual
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Provider Name | DENISE ALICIA HARRIS FNP
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Gender | Female
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Dates
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Enumeration Date | 09/21/2018
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Last Update Date | 06/13/2025
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Provider Practice Location Address
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Address Line | 1670 SCOTT BLVD STE 104
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City | DECATUR
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State | GA
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Zip | 30033-5645
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Country | US
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Telephone | 678-666-4033
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Fax |
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Provider Business Mailing Address
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Address Line | 1670 SCOTT BLVD STE 104
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City | DECATUR
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State | GA
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Zip | 30033-5645
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Country | US
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Telephone | 404-943-9996
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN161531
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License Number State | GA
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