Provider Demographics
NPI:1629304050
Name:HARPE, KARISA TIANA (ARNP)
Entity Type:Individual
Prefix:
First Name:KARISA
Middle Name:TIANA
Last Name:HARPE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 CALUMET PKWY STE 201
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30263-6734
Mailing Address - Country:US
Mailing Address - Phone:770-683-4538
Mailing Address - Fax:
Practice Address - Street 1:37 CALUMET PKWY STE 201
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30263-6734
Practice Address - Country:US
Practice Address - Phone:770-683-4538
Practice Address - Fax:770-683-4541
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-20
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN165046364SP0809X
MI4704409778363LP0808X
WAAP60911648363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult