Provider Demographics
NPI:1285449694
Name:HARRIS, ANNETTE MARIE
Entity type:Individual
Prefix:
First Name:ANNETTE
Middle Name:MARIE
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 1:2328 IMLAY AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:45015-1226
Mailing Address - Country:US
Mailing Address - Phone:513-226-1899
Mailing Address - Fax:
Practice Address - Street 1:2328 IMLAY AVE
Practice Address - Street 2:
Practice Address - City:FAIRFIELD TOWNSHIP
Practice Address - State:OH
Practice Address - Zip Code:45015-1226
Practice Address - Country:US
Practice Address - Phone:513-226-1899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-12
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No172A00000XOther Service ProvidersDriver
No251E00000XAgenciesHome Health
No251X00000XAgenciesSupports Brokerage
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant