Provider Demographics
NPI:1386680726
Name:HARRIS, NITA G (MD)
Entity Type:Individual
Prefix:MRS
First Name:NITA
Middle Name:G
Last Name:HARRIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 SOUTH CASCADE AVENUE
Mailing Address - Street 2:SUITE 140
Mailing Address - City:COLORADO SPRING
Mailing Address - State:CO
Mailing Address - Zip Code:80903-1604
Mailing Address - Country:US
Mailing Address - Phone:719-538-2900
Mailing Address - Fax:719-538-2961
Practice Address - Street 1:2222 N NEVADA AVE STE 4007
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-6863
Practice Address - Country:US
Practice Address - Phone:719-776-8500
Practice Address - Fax:719-776-4595
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO41223207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO31202870Medicaid
COC496808Medicare PIN
CO31202870Medicaid
F59083Medicare UPIN
CO31202870Medicaid
COC496808Medicare PIN