Provider Demographics
NPI:1548951270
Name:HARRIS, BRIANA (RN)
Entity type:Individual
Prefix:
First Name:BRIANA
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:176 CHERRY LAUREL DR
Mailing Address - Street 2:
Mailing Address - City:HAZEL GREEN
Mailing Address - State:AL
Mailing Address - Zip Code:35750-4200
Mailing Address - Country:US
Mailing Address - Phone:256-947-4756
Mailing Address - Fax:
Practice Address - Street 1:176 CHERRY LAUREL DR
Practice Address - Street 2:
Practice Address - City:HAZEL GREEN
Practice Address - State:AL
Practice Address - Zip Code:35750-4200
Practice Address - Country:US
Practice Address - Phone:256-947-4756
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-15
Last Update Date:2023-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251C00000X, 253Z00000X, 3747P1801X
AL1-127036163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No253Z00000XAgenciesIn Home Supportive Care
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant