Provider Demographics
NPI:1871196246
Name:HARRISON, DEBRA MARIE (CNA)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:MARIE
Last Name:HARRISON
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 171
Mailing Address - Street 2:
Mailing Address - City:NAPOLEON
Mailing Address - State:ND
Mailing Address - Zip Code:58561-0171
Mailing Address - Country:US
Mailing Address - Phone:701-425-2540
Mailing Address - Fax:
Practice Address - Street 1:513 BROADWAY
Practice Address - Street 2:
Practice Address - City:NAPOLEON
Practice Address - State:ND
Practice Address - Zip Code:58561-7440
Practice Address - Country:US
Practice Address - Phone:701-754-2291
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-18
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND23823747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant