Provider Demographics
NPI:1831408905
Name:HARRISON, NIVA NOKES (PT)
Entity type:Individual
Prefix:MS
First Name:NIVA
Middle Name:NOKES
Last Name:HARRISON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:NIVA
Other - Middle Name:ANN
Other - Last Name:NOKES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1105 W BYPASS
Mailing Address - Street 2:
Mailing Address - City:ANDALUSIA
Mailing Address - State:AL
Mailing Address - Zip Code:36420-5255
Mailing Address - Country:US
Mailing Address - Phone:334-222-5785
Mailing Address - Fax:334-222-0181
Practice Address - Street 1:1105 W BYPASS
Practice Address - Street 2:
Practice Address - City:ANDALUSIA
Practice Address - State:AL
Practice Address - Zip Code:36420-5255
Practice Address - Country:US
Practice Address - Phone:334-222-5785
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-06
Last Update Date:2010-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH 1256225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist