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Individual

MRS. DELORIS RENEE HARWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PNP-PC

Contact information

Practice address
104 E US HIGHWAY 80 STE 190, FORNEY, TX 75126
(469) 602-5277
(469) 995-7898
Mailing address
104 E US HIGHWAY 80 STE 190, FORNEY, TX 75126-8615
(469) 602-5277
(844) 881-1772

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP117846
TX
363LP0200X
Pediatric Nurse Practitioner
Primary
703123
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1346478252
TX
05
203992707
TX
Enumeration date
06/30/2009
Last updated
04/30/2020
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