Provider Demographics
NPI:1326724964
Name:HARRIS, TATIANNA ELAINE (FNP-C)
Entity type:Individual
Prefix:
First Name:TATIANNA
Middle Name:ELAINE
Last Name:HARRIS
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7607 BLACK WILLOW LN
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76002-4627
Mailing Address - Country:US
Mailing Address - Phone:214-402-9365
Mailing Address - Fax:
Practice Address - Street 1:120 N MILLER RD STE 100
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-9106
Practice Address - Country:US
Practice Address - Phone:682-341-7330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-27
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1127167363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily