MEDICARE: DR. PEI J HARRIS DNP, FNP-C

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	363LF0000X	Family Nurse Practitioner	A004465	AR
2	363LF0000X	Family Nurse Practitioner	201600346NP-PP	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366825341
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PEI J HARRIS DNP, FNP-C

Provider Business Mailing Address
First Line	:	1430 SCOTT LN
Second Line	:
City	:	NORTH BEND
State	:	OR
Zip	:	97459-2464
Country	:	US
Telephone Number	:	541-283-5662
Fax Number	:

Provider Business Practice Location Address
First Line	:	1430 SCOTT LN
Second Line	:
City	:	NORTH BEND
State	:	OR
Zip	:	97459-2464
Country	:	US
Telephone Number	:	541-283-5662
Fax Number	:

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

Provider Enumeration Date	:	07/08/2015
Last Update Date	:	05/11/2023

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