Provider Demographics
NPI:1487836490
Name:HARRIS, ANDREA DENISE (BS CRT)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:DENISE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:BS CRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3225 PERLINO DR
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37128-2873
Mailing Address - Country:US
Mailing Address - Phone:615-494-0743
Mailing Address - Fax:
Practice Address - Street 1:5901 BROKEN SOUND PKWY
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-2773
Practice Address - Country:US
Practice Address - Phone:800-875-8999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-30
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4005227800000X, 282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified
No282N00000XHospitalsGeneral Acute Care Hospital