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General NPI Number Information
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NPI Number | 1366033045
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Entity Type | Individual
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Provider Name | CARLA HARRIS
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Gender | Female
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Dates
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Enumeration Date | 01/27/2021
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Last Update Date | 01/27/2021
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Provider Practice Location Address
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Address Line | 101 HOSPITAL BLVD
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City | JEFFERSONVILLE
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State | IN
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Zip | 47130-3769
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Country | US
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Telephone | 812-282-3899
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Fax | 812-282-4172
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Provider Business Mailing Address
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Address Line | 101 HOSPITAL BLVD
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City | JEFFERSONVILLE
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State | IN
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Zip | 47130-3769
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Country | US
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Telephone | 812-282-3899
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Fax | 812-282-4172
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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 | 163WR0006X
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Taxonomy Name | Registered Nurse First Assistant
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License Number | 27039528A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 50085294
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 27039528A
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License Number State | IN
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