Provider Demographics
NPI:1023811007
Name:HARASEN, TERRI ANN
Entity type:Individual
Prefix:MRS
First Name:TERRI
Middle Name:ANN
Last Name:HARASEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 HEPNER ST SE
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32909-7672
Mailing Address - Country:US
Mailing Address - Phone:321-213-4558
Mailing Address - Fax:
Practice Address - Street 1:1401 HEPNER ST SE
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32909-7672
Practice Address - Country:US
Practice Address - Phone:321-213-4558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-27
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9468844163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse