Provider Demographics
NPI:1487801502
Name:HARRIS, ROBIN SUZANNE (CRNP)
Entity type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:SUZANNE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 AUTUMN VIEW DR
Mailing Address - Street 2:
Mailing Address - City:STERRETT
Mailing Address - State:AL
Mailing Address - Zip Code:35147-9221
Mailing Address - Country:US
Mailing Address - Phone:205-678-7036
Mailing Address - Fax:
Practice Address - Street 1:880 MONTCLAIR RD
Practice Address - Street 2:SUITE 577
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35213-1972
Practice Address - Country:US
Practice Address - Phone:205-595-6757
Practice Address - Fax:205-595-0472
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-20
Last Update Date:2009-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1099499363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily