Provider Demographics
NPI:1770981839
Name:HARRIS, JIN PING (RN60363464)
Entity type:Individual
Prefix:MRS
First Name:JIN
Middle Name:PING
Last Name:HARRIS
Suffix:
Gender:F
Credentials:RN60363464
Other - Prefix:MRS
Other - First Name:JIN
Other - Middle Name:PING
Other - Last Name:GUO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:N/A
Mailing Address - Street 1:PO BOX 262
Mailing Address - Street 2:
Mailing Address - City:POLACCA
Mailing Address - State:AZ
Mailing Address - Zip Code:86042
Mailing Address - Country:US
Mailing Address - Phone:253-275-8299
Mailing Address - Fax:
Practice Address - Street 1:HIGHWAY 264 MILE POST 388
Practice Address - Street 2:HOPI HEALTH CARE CENTER
Practice Address - City:POLACCA
Practice Address - State:AZ
Practice Address - Zip Code:86042
Practice Address - Country:US
Practice Address - Phone:928-737-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60363464163W00000X
AZAP10460363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse