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General NPI Number Information
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NPI Number | 1639647357
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Entity Type | Individual
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Provider Name | CHIVAS MICHELLE HARRIS FNP-C
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Gender | Female
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Dates
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Enumeration Date | 11/12/2018
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 325 N SAINT PAUL ST STE 3100
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City | DALLAS
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State | TX
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Zip | 75201-3923
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Country | US
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Telephone | 617-505-1520
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Fax |
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Provider Business Mailing Address
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Address Line | 1 CASTLE HILL RD
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City | SAVANNAH
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State | GA
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Zip | 31419-6602
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Country | US
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Telephone | 912-800-3733
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN221502
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License Number State | GA
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