Provider Demographics
NPI:1679255467
Name:HARRIS, JANA (FNP-BC)
Entity type:Individual
Prefix:MS
First Name:JANA
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 E 210TH ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-2401
Mailing Address - Country:US
Mailing Address - Phone:617-784-2053
Mailing Address - Fax:
Practice Address - Street 1:2045 STATE ROUTE 35 STE 200
Practice Address - Street 2:
Practice Address - City:SOUTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08879-2069
Practice Address - Country:US
Practice Address - Phone:929-207-4669
Practice Address - Fax:917-791-9755
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-02
Last Update Date:2025-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJRN307748363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily