Provider Demographics
NPI:1659890309
Name:HARRIS, JOY LYNN (BSN, RN, CPM, LM)
Entity Type:Individual
Prefix:MRS
First Name:JOY
Middle Name:LYNN
Last Name:HARRIS
Suffix:
Gender:F
Credentials:BSN, RN, CPM, LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 BENDITA LOMA
Mailing Address - Street 2:
Mailing Address - City:LOS LUNAS
Mailing Address - State:NM
Mailing Address - Zip Code:87031-6897
Mailing Address - Country:US
Mailing Address - Phone:505-358-1947
Mailing Address - Fax:
Practice Address - Street 1:24 BENDITA LOMA
Practice Address - Street 2:
Practice Address - City:LOS LUNAS
Practice Address - State:NM
Practice Address - Zip Code:87031-6897
Practice Address - Country:US
Practice Address - Phone:505-358-1947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-13
Last Update Date:2017-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR56509163W00000X
NM10078R176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No163W00000XNursing Service ProvidersRegistered Nurse