Provider Demographics
NPI:1154136919
Name:HARRIS, AYANNA
Entity type:Individual
Prefix:
First Name:AYANNA
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27725 HOOVER RD APT 8
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48093-4567
Mailing Address - Country:US
Mailing Address - Phone:313-662-8663
Mailing Address - Fax:
Practice Address - Street 1:27725 HOOVER RD APT 8
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093-4567
Practice Address - Country:US
Practice Address - Phone:313-662-8663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide