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NPI Code Detail

MEDICARE: YALONDA GRACE HARRIS FNP-C

MEDICARE:   YALONDA GRACE HARRIS  FNP-C
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 Practitioner1156122TX

General Provider Information

NPI Number : 1114788114
Entity Type Code : Individual
Provider Name (Legal Business Name) : YALONDA GRACE HARRIS FNP-C
Provider Business Mailing Address
First Line : 3515 RICHMOND RD
Second Line :
City : TEXARKANA
State : TX
Zip : 75503-0711
Country : US
Telephone Number : 903-791-9355
Fax Number : 903-793-0496
Provider Business Practice Location Address
First Line : 106 LOOP 59
Second Line :
City : ATLANTA
State : TX
Zip : 75551-2010
Country : US
Telephone Number : 903-796-9355
Fax Number : 903-796-9360
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/17/2024
Last Update Date : 12/03/2025

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Directions to “ YALONDA GRACE HARRIS FNP-C” Practice Location

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