Provider Demographics
NPI:1376532010
Name:HARRIS, DEVIN C (MS, FNP)
Entity Type:Individual
Prefix:
First Name:DEVIN
Middle Name:C
Last Name:HARRIS
Suffix:
Gender:F
Credentials:MS, FNP
Other - Prefix:
Other - First Name:DEVIN
Other - Middle Name:C
Other - Last Name:WELSH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSRN
Mailing Address - Street 1:3400 DATA DRIVE
Mailing Address - Street 2:CREDENTIALING
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7956
Mailing Address - Country:US
Mailing Address - Phone:530-676-2877
Mailing Address - Fax:
Practice Address - Street 1:1700 PRAIRIE CITY ROAD
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630
Practice Address - Country:US
Practice Address - Phone:916-351-4800
Practice Address - Fax:916-351-4899
Is Sole Proprietor?:No
Enumeration Date:2005-10-16
Last Update Date:2015-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12426363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily