Active NPI
Elyse Harry, FNP-C
- Family Nurse Practitioner
- Evansville, IN
National Provider Identifier
1043076896
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 71014944A
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 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
| License | State | Type | Specialty |
|---|---|---|---|
| 71014944A | IN | MD | Family 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.