Provider Demographics
NPI:1013594241
Name:HARRIS, NILE NEFERTARI (LPN)
Entity Type:Individual
Prefix:
First Name:NILE
Middle Name:NEFERTARI
Last Name:HARRIS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:818 READING RD
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-1342
Mailing Address - Country:US
Mailing Address - Phone:513-445-8866
Mailing Address - Fax:513-492-7674
Practice Address - Street 1:818 READING RD
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-1342
Practice Address - Country:US
Practice Address - Phone:513-445-8866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-25
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH143549164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse