Provider Demographics
NPI:1881435246
Name:HARPER, KURTIS WAYNE
Entity type:Individual
Prefix:
First Name:KURTIS
Middle Name:WAYNE
Last Name:HARPER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3036 STAFFORDSHIRE BLVD
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:TN
Mailing Address - Zip Code:37849-4254
Mailing Address - Country:US
Mailing Address - Phone:805-704-0989
Mailing Address - Fax:
Practice Address - Street 1:3036 STAFFORDSHIRE BLVD
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:TN
Practice Address - Zip Code:37849-4254
Practice Address - Country:US
Practice Address - Phone:805-704-0989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-01
Last Update Date:2024-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide