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General NPI Number Information
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NPI Number | 1881493492
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Entity Type | Individual
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Provider Name | MIA LUANA HARRIS RN
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Gender | Female
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Dates
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Enumeration Date | 03/08/2025
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Last Update Date | 09/23/2026
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Provider Practice Location Address
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Address Line | 736 CAMBRIDGE ST
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City | BRIGHTON
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State | MA
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Zip | 02135-2907
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Country | US
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Telephone | 617-789-3000
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Fax | 617-779-6352
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Provider Business Mailing Address
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Address Line | 23 RENE RD
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City | BROCKTON
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State | MA
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Zip | 02301-2132
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Country | US
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Telephone | 617-407-3558
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | RN2271053
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License Number State | MA
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