Provider Demographics
NPI:1780375758
Name:HARRISON, NATASHA F (RN)
Entity type:Individual
Prefix:
First Name:NATASHA
Middle Name:F
Last Name:HARRISON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6013 RED SPUR CT
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92336-4548
Mailing Address - Country:US
Mailing Address - Phone:323-595-7298
Mailing Address - Fax:909-574-1145
Practice Address - Street 1:6013 RED SPUR CT
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92336-4548
Practice Address - Country:US
Practice Address - Phone:323-595-7298
Practice Address - Fax:909-574-1145
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-18
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA719868163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse