Organization Active NPI

Jennifer Harris, Aprn, LLC

  • Family Nurse Practitioner
  • Russellville, AR
National Provider Identifier
1669315651
Registry record updated May 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
JENNIFER HARRIS, APRN, LLC
Practice address
169 Greystone LN
Russellville, AR 72802-2385
Phone
(479) 336-6642
Fax
(479) 227-5562
NPI assigned
Apr 13, 2026
Last updated
May 11, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2026

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

Authorized official

Name
Jennifer Harris, APRNNPI 1588053789
Title
Authorized Official
Phone
(479) 857-2442

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NU Primary

Addresses

Primary practice location

169 Greystone LN
Russellville, AR 72802-2385

Mailing address

PO Box 10054
Russellville, AR 72812-0054
Phone (479) 336-6642

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260608000930 AR Part B Supplier - Clinic/Group Practice 1850862186 Receives reassigned benefits from 1 practitioner
Practice locations: Russellville, AR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1776038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778457600000",
    "number": "1669315651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10054",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728120054",
            "telephone_number": "479-336-6642",
            "fax_number": "479-227-5562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 GREYSTONE LN",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728022385",
            "telephone_number": "479-336-6642",
            "fax_number": "479-227-5562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER HARRIS, APRN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-13",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "479-857-2442",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Russellville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.