# DR. JEZWAH E HARRIS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1609502657
- **Gender:** Man
- **Credential:** FNP-BC, MEP-C, NE-BC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207N00000X | Dermatology Physician | 11035589 | FL | — |
| 207R00000X | Internal Medicine Physician | 11035589 | FL | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | 11035589 | FL | — |
| 363L00000X | Nurse Practitioner | 314884 | AZ | — |
| 363L00000X | Nurse Practitioner | 355285 | NY | — |
| 363L00000X | Nurse Practitioner | 95031847 | CA | — |
| 363L00000X | Nurse Practitioner | APRN11035589 | FL | Yes |

## Other

- **Enumeration date:** 07/30/2022
- **Last updated:** 09/03/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 08375519 | — | NY |
| 05 | — | 100598895 | — | CA |
| 05 | — | 125974100 | — | FL |
| 05 | — | 127551600 | — | ID |
| 05 | — | 219931 | — | AZ |
| 05 | — | 246725900 | — | WY |
| 05 | — | 30005379330001 | — | KS |
| 05 | — | 6725466 | — | VT |
| 05 | — | 9000260404 | — | CO |
| 01 | — | ZJTEQ | BCBS FLORIDA BLUE | FL |