Provider Demographics
NPI:1225492788
Name:HARNOIS, ROSANNE (AGNP)
Entity Type:Individual
Prefix:
First Name:ROSANNE
Middle Name:
Last Name:HARNOIS
Suffix:
Gender:F
Credentials:AGNP
Other - Prefix:
Other - First Name:ROSE
Other - Middle Name:
Other - Last Name:HARNOIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:3031 NEW BERN AVE STE 306
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-2989
Mailing Address - Country:US
Mailing Address - Phone:919-231-3966
Mailing Address - Fax:919-231-3912
Practice Address - Street 1:3031 NEW BERN AVE STE 306
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610
Practice Address - Country:US
Practice Address - Phone:919-231-3966
Practice Address - Fax:919-231-3912
Is Sole Proprietor?:No
Enumeration Date:2016-04-11
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC174667163W00000X
NC5008506363LA2200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health