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General NPI Number Information
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NPI Number | 1609429612
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Entity Type | Individual
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Provider Name | LEAH DANIELLE HARRIS NP
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Gender | Female
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Dates
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Enumeration Date | 07/18/2019
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Last Update Date | 07/19/2019
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Provider Practice Location Address
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Address Line | 1900 COLUMBUS AVE
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City | BAY CITY
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State | MI
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Zip | 48708-6880
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Country | US
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Telephone | 989-894-3000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 153
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City | BRETHREN
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State | MI
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Zip | 49619-0153
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Country | US
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Telephone | 231-392-6117
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 4704289488
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | 4704289488
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 4704289488
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 4704289488
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License Number State | MI
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