Provider Demographics
NPI:1487828018
Name:HARRIS, LORRAINE S (APN,C)
Entity Type:Individual
Prefix:MRS
First Name:LORRAINE
Middle Name:S
Last Name:HARRIS
Suffix:
Gender:F
Credentials:APN,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 LIPPINCOTT DR STE 410
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4197
Mailing Address - Country:US
Mailing Address - Phone:856-355-0340
Mailing Address - Fax:856-355-0330
Practice Address - Street 1:1055 HADDON AVE
Practice Address - Street 2:
Practice Address - City:COLLINGSWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08108-2047
Practice Address - Country:US
Practice Address - Phone:856-854-4524
Practice Address - Fax:856-854-8216
Is Sole Proprietor?:No
Enumeration Date:2008-04-15
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO07055600163WX0003X
NJ26NN07055600363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0276111Medicaid
NJ226360Medicare PIN