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NPI Code Detail

MEDICARE: HARRISON FAMILY MEDICINE

MEDICARE: HARRISON FAMILY MEDICINE
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
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1225762867
Entity Type Code : Organization
Provider Name (Legal Business Name) : HARRISON FAMILY MEDICINE
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 : CO-OWNER
Name : MRS. DIANNE RENEE HARRISON
Credential : APRN
Telephone Number : 903-748-6386
Provider Enumeration Date : 07/11/2022
Last Update Date : 07/25/2022

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1033752803 — MRS. DIANNE RENEE HARRISON FNP
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Directions to “HARRISON FAMILY MEDICINE ” Practice Location

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