MEDICARE: SACHEEN DIAHN HARRIS CPNP-PC

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
1	363LP0200X	Pediatric Nurse Practitioner	CNP-03359	NM

General Provider Information

NPI Number	:	1225552094
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SACHEEN DIAHN HARRIS CPNP-PC

Provider Business Mailing Address
First Line	:	1 UNIVERSITY OF NEW MEXICO
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87131-0001
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 UNIVERSITY OF NEW MEXICO
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87131-3791
Country	:	US
Telephone Number	:	505-272-2111
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2017
Last Update Date	:	09/28/2023

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