Provider Demographics
NPI:1396115002
Name:HARRIS, CARLA (RN)
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6700 FLEET AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44105-3400
Mailing Address - Country:US
Mailing Address - Phone:216-496-2055
Mailing Address - Fax:
Practice Address - Street 1:21460 SHELDON RD
Practice Address - Street 2:C7
Practice Address - City:BROOKPARK
Practice Address - State:OH
Practice Address - Zip Code:44142-1232
Practice Address - Country:US
Practice Address - Phone:216-496-2055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-07
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH443927163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse