Individual
MRS. JEAN ANN HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, FNP-BC
Contact information
Practice address
1128 MEDICAL DR, TYLER, TX 75701-2109
(903) 593-8273
(903) 595-0204
Mailing address
PO BOX 603725, CHARLOTTE, NC 28260-3725
(828) 575-2625
(828) 350-2174
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP107523
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508884198
—
TX
01
—
816632
MEDICARE PTAN
TX
Enumeration date
07/18/2006
Last updated
10/31/2023
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