Provider Demographics
NPI:1073129136
Name:HARRIS, KAREN (ARNP, PMHNP- BC)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:ARNP, PMHNP- BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28211 CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:BROOKSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:34602-6232
Mailing Address - Country:US
Mailing Address - Phone:352-278-1398
Mailing Address - Fax:
Practice Address - Street 1:5664 SW 60TH AVE BLDG 4
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-5694
Practice Address - Country:US
Practice Address - Phone:813-666-2714
Practice Address - Fax:352-565-4131
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-23
Last Update Date:2023-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11007977101YM0800X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health