Miranda Kaye Harris, LPN

Individual provider Active NPI Licensed Practical Nurse · Prescott, AR

NPI 1528087475 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1528087475
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
L39920 (AR)
Practice address
1658 Hwy 371 West
Prescott, AR 71857
Phone
(870) 887-3660
Fax
(870) 887-3705
NPI assigned
Jul 19, 2006
Sex
Female
Sole proprietor
No

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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
L39920ARMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Arkansas Counseling and Mental Health Center, Inc Past Accepting new patients
Southwest Arkansas Counseling and Mental Health Center, Inc Past
since Dec 3, 2018
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X L39920 AR Yes

Addresses

Primary practice location

1658 Hwy 371 West
Prescott, AR 71857

Mailing address

2904 Arkansas Blvd
Texarkana, AR 71854-2536
Phone (870) 773-4655

Other providers in Prescott, AR

All providers in Prescott, AR · Licensed Practical Nurse in Arkansas

Sources for this page

Verify at the official NPI Registry.