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NPI Code Detail

MEDICARE: DEBORAHA WILLONETTE HARRIS C.R.N.P

MEDICARE: DEBORAHA WILLONETTE HARRIS C.R.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
1363L00000XNurse Practitioner1-021274AL

General Provider Information

NPI Number : 1811951874
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBORAHA WILLONETTE HARRIS C.R.N.P
Provider Business Mailing Address
First Line : 1700 AVENUE E
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35218-1543
Country : US
Telephone Number : 205-788-3321
Fax Number : 205-241-5260
Provider Business Practice Location Address
First Line : 1700 AVENUE E
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35218-1543
Country : US
Telephone Number : 205-788-3321
Fax Number : 205-241-5260
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2006
Last Update Date : 07/08/2007

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