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General NPI Number Information
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NPI Number | 1346478252
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Entity Type | Individual
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Provider Name | DELORIS RENEE HARWELL PNP-PC
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Gender | Female
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Dates
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Enumeration Date | 06/30/2009
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Last Update Date | 04/30/2020
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Provider Practice Location Address
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Address Line | 104 E US HIGHWAY 80 STE 190
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City | FORNEY
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State | TX
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Zip | 75126
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Country | US
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Telephone | 469-602-5277
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Fax | 469-995-7898
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Provider Business Mailing Address
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Address Line | 104 E US HIGHWAY 80 STE 190
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City | FORNEY
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State | TX
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Zip | 75126-8615
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Country | US
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Telephone | 469-602-5277
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Fax | 844-881-1772
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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 | AP117846
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 703123
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License Number State | TX
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