Provider Demographics
NPI:1851575930
Name:HARRIS, TARA SHARESE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:TARA
Middle Name:SHARESE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MRS
Other - First Name:TARA
Other - Middle Name:SHARESE
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:2000 PERIMETER PARK DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-8442
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6905 KNIGHTDALE BLVD STE 106
Practice Address - Street 2:
Practice Address - City:KNIGHTDALE
Practice Address - State:NC
Practice Address - Zip Code:27545-6506
Practice Address - Country:US
Practice Address - Phone:919-261-8760
Practice Address - Fax:919-261-8765
Is Sole Proprietor?:No
Enumeration Date:2007-12-24
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5003864363L00000X, 363LF0000X
NC0050-03864363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner