Provider Demographics
NPI:1982109765
Name:HARRIS, EMILEE RUXER (AGACNP)
Entity Type:Individual
Prefix:
First Name:EMILEE
Middle Name:RUXER
Last Name:HARRIS
Suffix:
Gender:F
Credentials:AGACNP
Other - Prefix:
Other - First Name:EMILEE
Other - Middle Name:RUTH
Other - Last Name:RUXER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6200 DUTCHMANS LN
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40205-3271
Mailing Address - Country:US
Mailing Address - Phone:502-456-6200
Mailing Address - Fax:502-456-6655
Practice Address - Street 1:6200 DUTCHMANS LN
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-3271
Practice Address - Country:US
Practice Address - Phone:502-456-6200
Practice Address - Fax:502-456-6655
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-26
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71013355A363L00000X, 363LA2200X, 363LA2100X, 363LF0000X, 363LG0600X
KY3012097363L00000X, 363LA2200X, 363LG0600X, 363LF0000X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily