Provider Demographics
NPI:1861036543
Name:HARRIS, DEBORAH (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
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 1:8555 16TH ST STE 700
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-2846
Mailing Address - Country:US
Mailing Address - Phone:240-839-7333
Mailing Address - Fax:
Practice Address - Street 1:6405 CHILLUM PL NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20012-2133
Practice Address - Country:US
Practice Address - Phone:202-291-3672
Practice Address - Fax:202-545-0392
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-05
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1013606163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse