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Individual
CAROLYN K HARRIS
Active
Individual
CAROLYN K HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0017000378
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
013531C83
MEDICARE PROVIDER NUMBER PRIOR TO 09/01/07
—
01
—
014912C58
MEDICARE INDIVIDUAL PTAN EFFECTIVE TO 09/01/07
—
05
—
1083697262
—
VA
01
—
1407936941
CVFP SITE ID
—
01
—
1528155892
CORPORATE NPI NUMBER
—
01
—
C03658
MEDICARE GROUP PTAN EFFECTIVE 09/01/07
—
01
—
C08183
MEDICARE GROUP NUMBER PRIOR TO 09/01/07
—
01
—
P00667138
MEDICARE RAILROAD
—
Enumeration date
11/22/2005
Last updated
03/06/2009
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