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NPI Code Detail

MEDICARE: TASHENNA HARRIS ARNP

MEDICARE: TASHENNA HARRIS ARNP
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 PractitionerARNP9214567FL

General Provider Information

NPI Number : 1164965174
Entity Type Code : Individual
Provider Name (Legal Business Name) : TASHENNA HARRIS ARNP
Provider Business Mailing Address
First Line : 1918 BLANDING BLVD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32210-3202
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1918 BLANDING BLVD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32210-3202
Country : US
Telephone Number : 904-389-6955
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/22/2016
Last Update Date : 11/22/2016

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Directions to “ TASHENNA HARRIS ARNP” Practice Location

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