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General NPI Number Information
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NPI Number | 1275231227
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Entity Type | Individual
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Provider Name | SHANIQUA HARRIS CNM, WHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 02/20/2023
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Last Update Date | 11/22/2024
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Provider Practice Location Address
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Address Line | 821 E KING ST
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City | KINGS MOUNTAIN
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State | NC
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Zip | 28086-3186
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Country | US
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Telephone | 980-487-2800
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Fax |
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Provider Business Mailing Address
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Address Line | 821 E KING ST
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City | KINGS MOUNTAIN
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State | NC
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Zip | 28086-3186
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Country | US
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Telephone | 980-487-2800
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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 | 163WX0003X
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Taxonomy Name | Inpatient Obstetric Registered Nurse
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License Number | 318264
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 5021124
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License Number State | NC
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