Provider Demographics
NPI:1316373038
Name:HARRIS, TERESA GAIL (NP-C, CWS)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:GAIL
Last Name:HARRIS
Suffix:
Gender:
Credentials:NP-C, CWS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1211 UNION AVE STE 330
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-6655
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:57 GERMANTOWN CT STE 204
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-4483
Practice Address - Country:US
Practice Address - Phone:901-758-7840
Practice Address - Fax:901-758-7771
Is Sole Proprietor?:No
Enumeration Date:2013-09-26
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR885045363LF0000X
TN24930363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily