Provider Demographics
NPI:1508402108
Name:HARRIS, COURTNEY ANN (NP-C)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:ANN
Last Name:HARRIS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 SANDY CORNER RD
Mailing Address - Street 2:
Mailing Address - City:EL CAMPO
Mailing Address - State:TX
Mailing Address - Zip Code:77437-9535
Mailing Address - Country:US
Mailing Address - Phone:979-543-5510
Mailing Address - Fax:
Practice Address - Street 1:591 FM 616
Practice Address - Street 2:
Practice Address - City:BLESSING
Practice Address - State:TX
Practice Address - Zip Code:77419
Practice Address - Country:US
Practice Address - Phone:979-475-6270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-19
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP142653363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner