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General NPI Number Information
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NPI Number | 1427600469
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Entity Type | Individual
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Provider Name | KYTRENA L HARRIS
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Gender | Female
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Dates
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Enumeration Date | 07/10/2019
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Last Update Date | 07/01/2025
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Provider Practice Location Address
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Address Line | 3618 J DEWEY GRAY CIR
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City | AUGUSTA
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State | GA
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Zip | 30909-1867
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Country | US
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Telephone | 731-394-1145
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Fax |
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Provider Business Mailing Address
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Address Line | 232 SEATON AVE
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City | GROVETOWN
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State | GA
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Zip | 30813-4259
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Country | US
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Telephone | 478-494-8441
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | RN196971
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN196971
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License Number State | GA
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