Provider Demographics
NPI:1659121168
Name:HARRIS, KATRINA ELLEN EVANS (RNC)
Entity Type:Individual
Prefix:MRS
First Name:KATRINA
Middle Name:ELLEN EVANS
Last Name:HARRIS
Suffix:
Gender:F
Credentials:RNC
Other - Prefix:MISS
Other - First Name:KATRINA
Other - Middle Name:ELLEN
Other - Last Name:EVANS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RNC
Mailing Address - Street 1:28 E WOODS DR
Mailing Address - Street 2:
Mailing Address - City:LITITZ
Mailing Address - State:PA
Mailing Address - Zip Code:17543-8643
Mailing Address - Country:US
Mailing Address - Phone:717-327-1696
Mailing Address - Fax:
Practice Address - Street 1:1097 COMMERCIAL AVE
Practice Address - Street 2:
Practice Address - City:EAST PETERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17520-1648
Practice Address - Country:US
Practice Address - Phone:717-696-9590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-26
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN675440163WM0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn