Provider Demographics
NPI:1275180044
Name:HARRIS, TAMYRA MICHELLE
Entity Type:Individual
Prefix:
First Name:TAMYRA
Middle Name:MICHELLE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5037 GREENE ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19144-2969
Mailing Address - Country:US
Mailing Address - Phone:484-401-4747
Mailing Address - Fax:
Practice Address - Street 1:5037 GREENE ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19144-2969
Practice Address - Country:US
Practice Address - Phone:484-401-4747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-26
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula