Individual
OLIVIA A HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN,RN,CPNP-PC
Contact information
Practice address
4102 24TH ST, LUBBOCK, TX 79410
(806) 773-9509
Mailing address
4102 24TH ST STE 507, LUBBOCK, TX 79410-1805
(806) 743-7334
(806) 743-7332
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
AP135653
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12281808
—
NM
01
—
1902318736
FIRSTCARE
TX
05
—
20173606
—
TX
05
—
378208803
—
TX
01
—
619098YKT8
MEDICARE
TX
01
—
8HT545
BCBS
TX
Enumeration date
11/02/2017
Last updated
06/18/2018
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