Provider Demographics
NPI:1326180050
Name:HARRIS, BARBARA ANN (RNC WHNP)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANN
Last Name:HARRIS
Suffix:
Gender:F
Credentials:RNC WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 SERVICE RD
Mailing Address - Street 2:A201
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48824-7015
Mailing Address - Country:US
Mailing Address - Phone:517-884-2976
Mailing Address - Fax:517-432-3928
Practice Address - Street 1:463 E CIRCLE DR
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48824-7500
Practice Address - Country:US
Practice Address - Phone:517-884-6546
Practice Address - Fax:517-432-9460
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2016-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704146549363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1326180050Medicaid
MI5008702910OtherBLUE CROSS BLUE SHIELD
MI1326180050Medicaid