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NPI Code Detail

MEDICARE: JENNIFER HARRIS APRN

MEDICARE: JENNIFER HARRIS APRN
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
1363LF0000XFamily Nurse PractitionerA004265AR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2A004265OTHERARAPRN

General Provider Information

NPI Number : 1588053789
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER HARRIS APRN
Provider Business Mailing Address
First Line : PO BOX 10054
Second Line :
City : RUSSELLVILLE
State : AR
Zip : 72812-0054
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 111 N ORANGE AVE STE 800
Second Line :
City : ORLANDO
State : FL
Zip : 32801-2381
Country : US
Telephone Number : 888-731-8994
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/12/2015
Last Update Date : 04/10/2026

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