Provider Demographics
NPI:1528671476
Name:HARRIS, CURNIFA FREDRICA
Entity type:Individual
Prefix:
First Name:CURNIFA
Middle Name:FREDRICA
Last Name:HARRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5100 SWEETBRIAR LN APT 217
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-3847
Mailing Address - Country:US
Mailing Address - Phone:954-549-6971
Mailing Address - Fax:
Practice Address - Street 1:5100 SWEETBRIAR LN APT 217
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-3847
Practice Address - Country:US
Practice Address - Phone:954-549-6971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX352790164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse