MEDICARE: MS. OLIVIA DAWN HARRIS

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	374J00000X	Doula		TN

General Provider Information

NPI Number	:	1720942717
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. OLIVIA DAWN HARRIS

Provider Business Mailing Address
First Line	:	6080 TOWN CREEK RD E
Second Line	:
City	:	LENOIR CITY
State	:	TN
Zip	:	37772-5618
Country	:	US
Telephone Number	:	865-686-2107
Fax Number	:

Provider Business Practice Location Address
First Line	:	1416 BREDA DR
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37918-1401
Country	:	US
Telephone Number	:	865-686-2107
Fax Number	:

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

Provider Enumeration Date	:	12/12/2025
Last Update Date	:	12/12/2025

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