MEDICARE: DEBORAH HARRIS REGISTERED NURSE

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	163W00000X	Registered Nurse	RN1013606	DC

General Provider Information

NPI Number	:	1861036543
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH HARRIS REGISTERED NURSE

Provider Business Mailing Address
First Line	:	8555 16TH ST STE 700
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20910-2846
Country	:	US
Telephone Number	:	240-839-7333
Fax Number	:

Provider Business Practice Location Address
First Line	:	6405 CHILLUM PL NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20012-2133
Country	:	US
Telephone Number	:	202-291-3672
Fax Number	:	202-545-0392

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

Provider Enumeration Date	:	11/05/2019
Last Update Date	:	11/05/2019

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