Harris, Carolyn M

Harris, Carolyn M is an individual health care provider with primary practice located at 1045 Wyatt Way , Lizton IN 46149-9583. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Community Health, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Harris, Carolyn M can be contacted via phone (317) 994-6600.

Contact Information

Primary practice address
1045 Wyatt Way Lizton IN 46149-9583
Phone: (317) 994-6600
Fax: (317) 994-6605
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Community Health 363LC1500X 28144501A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 71002313A Indiana

Profile Details

NPI number 1871644278
LBN Legal business name Harris, Carolyn M
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 15th, 2007
Last updated Mar 5th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871644278 NPPES
Indiana MEDICAID 100419730

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