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General NPI Number Information
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NPI Number | 1902751126
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Entity Type | Individual
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Provider Name | NICOLE HARRIS RN, BSN
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Gender | Female
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Dates
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Enumeration Date | 03/03/2026
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Last Update Date | 03/03/2026
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Provider Practice Location Address
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Address Line | 1007 MEMORIAL DR
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City | GRIFFIN
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State | GA
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Zip | 30223-4445
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Country | US
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Telephone | 770-467-4740
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Fax | 770-467-4740
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Provider Business Mailing Address
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Address Line | 508 VAN BUREN RD
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City | BARNESVILLE
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State | GA
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Zip | 30204-3152
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Country | US
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Telephone | 678-794-9071
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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 | RN241406
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License Number State | GA
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