Provider Demographics
NPI:1760880801
Name:HARRISON, NANCY JO (RN-BC)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:JO
Last Name:HARRISON
Suffix:
Gender:F
Credentials:RN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2031 S MOLINE WAY
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-1119
Mailing Address - Country:US
Mailing Address - Phone:317-506-7015
Mailing Address - Fax:
Practice Address - Street 1:4500 CHERRY CREEK DRIVE SOUTH
Practice Address - Street 2:SUITE 940
Practice Address - City:GLENDALE
Practice Address - State:CO
Practice Address - Zip Code:80246
Practice Address - Country:US
Practice Address - Phone:303-322-7108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-05
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1624489163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse