Provider Demographics
NPI:1699663427
Name:HARRIS, KORYN NOELLE (APRN)
Entity type:Individual
Prefix:
First Name:KORYN
Middle Name:NOELLE
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 1:13723 ATLANTIC BLVD APT 404
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32225-4234
Mailing Address - Country:US
Mailing Address - Phone:201-638-2243
Mailing Address - Fax:
Practice Address - Street 1:13723 ATLANTIC BLVD APT 404
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32225-4234
Practice Address - Country:US
Practice Address - Phone:201-638-2243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-27
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11040296363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care