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NPI 1902318736

NPI 1902318736 : OLIVIA A HARRIS MSN,RN,CPNP-PC : LUBBOCK, TX

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General NPI Number Information
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    NPI Number           |    1902318736
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    Entity Type          |    Individual 
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    Provider Name        |    OLIVIA A HARRIS MSN,RN,CPNP-PC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/02/2017
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    Last Update Date     |    06/18/2018
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Provider Practice Location Address
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    Address Line         |    4102 24TH ST 
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    City                 |    LUBBOCK
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    State                |    TX
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    Zip                  |    79410
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    Country              |    US
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    Telephone            |    806-773-9509
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    4102 24TH ST STE 507 
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    City                 |    LUBBOCK
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    State                |    TX
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    Zip                  |    79410-1805
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    Country              |    US
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    Telephone            |    806-743-7334
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    Fax                  |    806-743-7332
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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        |    363LP0200X
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    Taxonomy Name        |    Pediatric Nurse Practitioner
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    License Number       |    AP135653
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    License Number State |    TX
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