Provider Demographics
NPI:1700289741
Name:HARPER, AMY DEANN (AP126288)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:DEANN
Last Name:HARPER
Suffix:
Gender:F
Credentials:AP126288
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16015 WIMBLEDON CHAMPIONS DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-7689
Mailing Address - Country:US
Mailing Address - Phone:281-379-2066
Mailing Address - Fax:
Practice Address - Street 1:16015 WIMBLEDON CHAMPIONS DR
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-7689
Practice Address - Country:US
Practice Address - Phone:281-379-2066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-05
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP126288363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily