Provider Demographics
NPI:1427875939
Name:AUSTIN-HARRIS, KRISTEN E (APRN)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:E
Last Name:AUSTIN-HARRIS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 BELLEWOOD ST
Mailing Address - Street 2:
Mailing Address - City:TITUSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32780-8135
Mailing Address - Country:US
Mailing Address - Phone:321-544-9220
Mailing Address - Fax:
Practice Address - Street 1:2525 GARDEN ST
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32796-2549
Practice Address - Country:US
Practice Address - Phone:321-966-2646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-25
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11034912363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily