MEDICARE: DENISE HARRISON

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	363LA2200X	Adult Health Nurse Practitioner	APRN.CNP.021060	OH
2	363LG0600X	Gerontology Nurse Practitioner	APRN.CNP.021060	OH

General Provider Information

NPI Number	:	1255851176
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENISE HARRISON

Provider Business Mailing Address
First Line	:	419 HILLCREST DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45215-2501
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	419 HILLCREST DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45215-2501
Country	:	US
Telephone Number	:	757-581-3154
Fax Number	:

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

Provider Enumeration Date	:	06/21/2017
Last Update Date	:	07/06/2023

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Directions to “ DENISE HARRISON ” Practice Location

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