MEDICARE: MS. TRACY R. HARRIS FNP-BC

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	363LF0000X	Family Nurse Practitioner	AP05306	LA
2	101Y00000X	Counselor	AP05306	LA

General Provider Information

NPI Number	:	1972782787
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TRACY R. HARRIS FNP-BC

Provider Business Mailing Address
First Line	:	4056 OLD GENTILLY RD
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70126-4813
Country	:	US
Telephone Number	:	504-944-8889
Fax Number	:	504-948-9810

Provider Business Practice Location Address
First Line	:	4056 OLD GENTILLY RD
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70126-4813
Country	:	US
Telephone Number	:	504-944-8889
Fax Number	:	504-948-9810

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

Provider Enumeration Date	:	10/29/2007
Last Update Date	:	08/16/2016

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