Provider Demographics
NPI:1164724712
Name:HARRISON, JENNIFER LEIGH (RN, NP-C)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LEIGH
Last Name:HARRISON
Suffix:
Gender:F
Credentials:RN, NP-C
Other - Prefix:MRS
Other - First Name:JENNIFER
Other - Middle Name:LEIGH
Other - Last Name:CHRISTOFFERSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, NP-C
Mailing Address - Street 1:6626 STATION DR
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:GA
Mailing Address - Zip Code:30527-1559
Mailing Address - Country:US
Mailing Address - Phone:706-499-8351
Mailing Address - Fax:
Practice Address - Street 1:7938 STRATFORD LN
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30350-4159
Practice Address - Country:US
Practice Address - Phone:770-804-9479
Practice Address - Fax:770-396-7942
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-01
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN159235 NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily