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NPI Code Detail

MEDICARE: DESTINY HARRIS

MEDICARE: DESTINY HARRIS
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1215868179
Entity Type Code : Individual
Provider Name (Legal Business Name) : DESTINY HARRIS
Provider Business Mailing Address
First Line : 6210 BASELINE RD
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72209-4728
Country : US
Telephone Number : 501-265-0302
Fax Number : 501-265-0300
Provider Business Practice Location Address
First Line : 6210 BASELINE RD
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72209-4728
Country : US
Telephone Number : 501-265-0302
Fax Number : 501-265-0300
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/28/2026
Last Update Date : 05/28/2026

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Directions to “ DESTINY HARRIS ” Practice Location

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