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General NPI Number Information
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NPI Number | 1144841446
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Entity Type | Individual
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Provider Name | THERESA LYNNE HARNAGE
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Gender | Female
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Dates
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Enumeration Date | 04/28/2020
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Last Update Date | 04/28/2020
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Provider Practice Location Address
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Address Line | 2711 LANE ST
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City | KANNAPOLIS
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State | NC
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Zip | 28083-9217
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Country | US
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Telephone | 704-403-4800
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Fax |
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Provider Business Mailing Address
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Address Line | 802 TREVA ANNE DR SW
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City | CONCORD
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State | NC
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Zip | 28027-3907
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Country | US
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Telephone | 704-281-6586
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Fax | 863-241-0721
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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 | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | 258408
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License Number State | NC
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