Provider Demographics
NPI:1083039671
Name:HARRIS, LAURA (CRNP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 ADAMS ST SE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-3730
Mailing Address - Country:US
Mailing Address - Phone:256-265-7896
Mailing Address - Fax:256-265-2863
Practice Address - Street 1:910 ADAMS ST SE
Practice Address - Street 2:SUITE 110
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-3730
Practice Address - Country:US
Practice Address - Phone:256-265-7896
Practice Address - Fax:256-265-2863
Is Sole Proprietor?:No
Enumeration Date:2014-02-19
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-121932363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily