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NPI Code Detail

MEDICARE: MRS. DIANNE RENEE HARRISON FNP

MEDICARE: MRS. DIANNE RENEE HARRISON FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerAP143675TX
2363LF0000XFamily Nurse Practitioner122102AR

General Provider Information

NPI Number : 1033752803
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DIANNE RENEE HARRISON FNP
Provider Business Mailing Address
First Line : 218 CHURCH ST
Second Line :
City : STAMPS
State : AR
Zip : 71860-2816
Country : US
Telephone Number : 870-533-1300
Fax Number : 870-533-1303
Provider Business Practice Location Address
First Line : 218 CHURCH ST
Second Line :
City : STAMPS
State : AR
Zip : 71860-2816
Country : US
Telephone Number : 870-533-1300
Fax Number : 870-533-1303
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2019
Last Update Date : 08/31/2022

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