Provider Demographics
NPI:1427810621
Name:KING-HARRIS, MAGGIE (NP)
Entity type:Individual
Prefix:
First Name:MAGGIE
Middle Name:
Last Name:KING-HARRIS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:176 S BECKFORD DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NC
Mailing Address - Zip Code:27536-2584
Mailing Address - Country:US
Mailing Address - Phone:252-492-2161
Mailing Address - Fax:252-438-2888
Practice Address - Street 1:816 US HIGHWAY 158 BUSINESS WEST, SUITE 102
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:NC
Practice Address - Zip Code:27589-9788
Practice Address - Country:US
Practice Address - Phone:252-257-6213
Practice Address - Fax:252-257-3286
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-24
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCF10231176363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily