Provider Demographics
NPI:1962985309
Name:HARRIS, JATIFHA CEDEYA (NP)
Entity type:Individual
Prefix:MS
First Name:JATIFHA
Middle Name:CEDEYA
Last Name:HARRIS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:JATIFHA
Other - Middle Name:CEDEYA
Other - Last Name:FELTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:856 J CLYDE MORRIS BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23601-1318
Mailing Address - Country:US
Mailing Address - Phone:757-316-5800
Mailing Address - Fax:757-534-5190
Practice Address - Street 1:12200 WARWICK BLVD STE 410
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23601-2548
Practice Address - Country:US
Practice Address - Phone:757-534-5200
Practice Address - Fax:757-534-5830
Is Sole Proprietor?:No
Enumeration Date:2018-09-12
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024176593363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care