MEDICARE: NAKITA L 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1831960707
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NAKITA L HARRIS

Provider Business Mailing Address
First Line	:	1542 EDDINGTON RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44118-1129
Country	:	US
Telephone Number	:	216-699-2532
Fax Number	:

Provider Business Practice Location Address
First Line	:	1542 EDDINGTON RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44118-1129
Country	:	US
Telephone Number	:	216-699-2532
Fax Number	:

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

Provider Enumeration Date	:	01/10/2024
Last Update Date	:	01/10/2024

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