Provider Demographics
NPI:1811326473
Name:HARRIS, PAIGE WATSON (NP-C)
Entity type:Individual
Prefix:MRS
First Name:PAIGE
Middle Name:WATSON
Last Name:HARRIS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 STACY LN
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-1176
Mailing Address - Country:US
Mailing Address - Phone:229-724-8623
Mailing Address - Fax:
Practice Address - Street 1:1044 WASHINGTON AVE STE 102
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-0655
Practice Address - Country:US
Practice Address - Phone:478-795-7422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-04
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71004704A363LF0000X
IN71004704B363LF0000X
GARN203807363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily