Individual provider Active NPI

Lula Harris, ASN, RN

  • Registered Nurse
  • Poplar Bluff, MO
National Provider Identifier
1316448079
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
133422 Issued in MO
Practice address
101 S Main St
Poplar Bluff, MO 63901-5843
Phone
(573) 686-5090
NPI assigned
Feb 27, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 133422 MO Primary

Addresses

Primary practice location

101 S Main St
Poplar Bluff, MO 63901-5843

Mailing address

PO Box 459
Farmington, MO 63640-0459

Other practice location 1

916 Smith St
Dexter, MO 63841-2737
Phone (573) 624-6937

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
133422MOMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Missouri Behavioral Health Inc Past Accepting new patients
Southeast Missouri Behavioral Health Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1519689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1316448079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 459",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636400459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S MAIN ST",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639015843",
            "telephone_number": "573-686-5090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "916 Smith St",
            "address_purpose": "LOCATION",
            "city": "Dexter",
            "state": "MO",
            "postal_code": "638412737",
            "country_code": "US",
            "telephone_number": "573-624-6937",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "LULA",
        "credential": "ASN, RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-27",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "133422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poplar Bluff, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.