Provider Demographics
NPI:1497800874
Name:HARCHIS, DIANA MICHELLE 'MICKEY' (RN)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:MICHELLE 'MICKEY'
Last Name:HARCHIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 BEELER LOOP RD
Mailing Address - Street 2:
Mailing Address - City:GREENBACK
Mailing Address - State:TN
Mailing Address - Zip Code:37742-2594
Mailing Address - Country:US
Mailing Address - Phone:865-856-9630
Mailing Address - Fax:
Practice Address - Street 1:600 RAYDER AVE
Practice Address - Street 2:
Practice Address - City:LOUDON
Practice Address - State:TN
Practice Address - Zip Code:37774-1050
Practice Address - Country:US
Practice Address - Phone:865-458-2662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000056186163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNRN0000056186OtherRN LICENSE