Provider Demographics
NPI:1114516267
Name:HARRIS, ERIN K (NP)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:K
Last Name:HARRIS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 REID PKWY
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:IN
Mailing Address - Zip Code:47374-1157
Mailing Address - Country:US
Mailing Address - Phone:765-935-8877
Mailing Address - Fax:765-939-2761
Practice Address - Street 1:2507 CHESTER BLVD SPC B
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:IN
Practice Address - Zip Code:47374-1105
Practice Address - Country:US
Practice Address - Phone:765-935-8877
Practice Address - Fax:765-939-2761
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-13
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71010826A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily