Provider Demographics
NPI:1639990682
Name:HARRIS, CHRISTIE JO (RN, CA-SANE)
Entity type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:JO
Last Name:HARRIS
Suffix:
Gender:F
Credentials:RN, CA-SANE
Other - Prefix:
Other - First Name:CHRISTIE
Other - Middle Name:JO
Other - Last Name:CLINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:3801 TATONKA DR
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76549-3906
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3801 TATONKA DR
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76549-3906
Practice Address - Country:US
Practice Address - Phone:254-553-8745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-22
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX783206163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency