Provider Demographics
NPI:1659032118
Name:HARRIS, ELISABETH FRANCIS (APRN)
Entity Type:Individual
Prefix:
First Name:ELISABETH
Middle Name:FRANCIS
Last Name:HARRIS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2564 COPPERHEAD LN
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:FL
Mailing Address - Zip Code:32046-5836
Mailing Address - Country:US
Mailing Address - Phone:912-253-2374
Mailing Address - Fax:
Practice Address - Street 1:2564 COPPERHEAD LN
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:FL
Practice Address - Zip Code:32046-5836
Practice Address - Country:US
Practice Address - Phone:912-253-2374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-06
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11017080363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner