Individual provider Active NPI

Elyse Harry, FNP-C

  • Family Nurse Practitioner
  • Evansville, IN
National Provider Identifier
1043076896
Registry record updated Feb 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71014944A Issued in IN
Practice address
4972 Lincoln Ave Ste 101
Evansville, IN 47715-7909
Phone
(812) 598-2124
NPI assigned
Feb 27, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 71014944A IN Primary

Addresses

Primary practice location

4972 Lincoln Ave Ste 101
Evansville, IN 47715-7909

Mailing address

4972 Lincoln Ave Ste 101
Evansville, IN 47715-7909
Phone (812) 598-2124

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
71014944AINMDFamily Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1708992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1043076896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4972 LINCOLN AVE STE 101",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477157909",
            "telephone_number": "812-598-2124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4972 LINCOLN AVE STE 101",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477157909",
            "telephone_number": "812-598-2124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRY",
        "first_name": "ELYSE",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-27",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71014944A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.