Provider Demographics
NPI:1215109061
Name:HARRIS, LUCINDA LEE (CRNP)
Entity type:Individual
Prefix:MRS
First Name:LUCINDA
Middle Name:LEE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:400 E 2ND ST
Mailing Address - Street 2:RM. 324 KUB, BLOOMSBURG UNIVERSITY OF PA
Mailing Address - City:BLOOMSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17815-1301
Mailing Address - Country:US
Mailing Address - Phone:570-389-4451
Mailing Address - Fax:570-389-3417
Practice Address - Street 1:400 E 2ND ST
Practice Address - Street 2:RM. 324 KUB, BLOOMSBURG UNIVERSITY OF PA
Practice Address - City:BLOOMSBURG
Practice Address - State:PA
Practice Address - Zip Code:17815-1301
Practice Address - Country:US
Practice Address - Phone:570-389-4451
Practice Address - Fax:570-389-3417
Is Sole Proprietor?:No
Enumeration Date:2008-04-01
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATP001815B363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner