Provider Demographics
NPI:1790087385
Name:HARRIS, JULIA ARNETTE (REGISTERED NURSE)
Entity Type:Individual
Prefix:MS
First Name:JULIA
Middle Name:ARNETTE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2354 E. 18TH ST.
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-4417
Mailing Address - Country:US
Mailing Address - Phone:718-891-5371
Mailing Address - Fax:
Practice Address - Street 1:2354 E. 18TH ST.
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-4417
Practice Address - Country:US
Practice Address - Phone:718-891-5371
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-02
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY236701-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY$$$$$$$$$-AMedicare UPIN