Provider Demographics
NPI:1639297161
Name:ARLINE-HARRIS, JAMIE VERNISE (LVN)
Entity Type:Individual
Prefix:MS
First Name:JAMIE
Middle Name:VERNISE
Last Name:ARLINE-HARRIS
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14122 GALE DR
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92394-7442
Mailing Address - Country:US
Mailing Address - Phone:760-843-5443
Mailing Address - Fax:
Practice Address - Street 1:14122 GALE DR
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92394-7442
Practice Address - Country:US
Practice Address - Phone:760-843-5443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN153811164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse