Provider Demographics
NPI:1679377584
Name:HARRIS, ROYAL JOVANNE
Entity type:Individual
Prefix:
First Name:ROYAL
Middle Name:JOVANNE
Last Name:HARRIS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1021 GALT ST
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23504-2541
Mailing Address - Country:US
Mailing Address - Phone:757-349-4739
Mailing Address - Fax:757-349-4739
Practice Address - Street 1:1021 GALT ST
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23504-2541
Practice Address - Country:US
Practice Address - Phone:757-349-4739
Practice Address - Fax:757-349-4739
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1417262056251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health