Provider Demographics
NPI:1477785731
Name:HARRIS, DONNA CHRISTINE (APN)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:CHRISTINE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2086 RIVERDALE RD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38138-4543
Mailing Address - Country:US
Mailing Address - Phone:901-522-6249
Mailing Address - Fax:901-522-6249
Practice Address - Street 1:5959 PARK AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:SHELBY COUNTY
Practice Address - Zip Code:38119
Practice Address - Country:UM
Practice Address - Phone:901-764-3324
Practice Address - Fax:901-765-3294
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-19
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000014309364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health