MEDICARE: MS. CONSTANCE ANNEMARIE HARRIS F.N.P.

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	363L00000X	Nurse Practitioner	302898	CA
2	363LF0000X	Family Nurse Practitioner	9936	CA

General Provider Information

NPI Number	:	1598736498
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CONSTANCE ANNEMARIE HARRIS F.N.P.

Provider Business Mailing Address
First Line	:	3656 W SHAW AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93711-3231
Country	:	US
Telephone Number	:	559-388-8430
Fax Number	:

Provider Business Practice Location Address
First Line	:	2174 N ANTIOCH AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93722-7310
Country	:	US
Telephone Number	:	559-277-9892
Fax Number	:

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

Provider Enumeration Date	:	01/30/2006
Last Update Date	:	11/21/2023

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