Provider Demographics
NPI:1992957575
Name:HARRIS, PAIGE C (CRNP)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:C
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 1:1722 PINE ST STE 700
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36106-1125
Mailing Address - Country:US
Mailing Address - Phone:334-834-1300
Mailing Address - Fax:334-834-8347
Practice Address - Street 1:1722 PINE ST STE 700
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-1125
Practice Address - Country:US
Practice Address - Phone:334-834-1300
Practice Address - Fax:334-834-8347
Is Sole Proprietor?:No
Enumeration Date:2008-10-15
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL01-097607363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL01-097607OtherNURSING LICENSE