Provider Demographics
NPI:1528223906
Name:HARRIS, HEATHER RAE (FNP)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:RAE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:500 E WINDMILL LN
Mailing Address - Street 2:STE 125
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123
Mailing Address - Country:US
Mailing Address - Phone:702-263-4795
Mailing Address - Fax:702-263-4804
Practice Address - Street 1:500 E WINDMILL LN
Practice Address - Street 2:STE 125
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123
Practice Address - Country:US
Practice Address - Phone:702-263-4795
Practice Address - Fax:702-263-4804
Is Sole Proprietor?:No
Enumeration Date:2008-07-24
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPN001053207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine