Theresa Lyon Harris, APRN
Nurse Practitioner in Ponte Vedra Beach, FL. Individual provider (NPI-1).
NPI number1871849596
StatusActive
Last updated in NPPESApr 14, 2023
Details
- NPI
- 1871849596
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Theresa Lyon Harris
- Credential
- APRN
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 31, 2012
- Certification date
- Apr 14, 2023
- Last updated
- Apr 14, 2023
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - NURSE PRACTITIONER
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | APRN1371502 | FL | Yes |
| 363L00000X | Nurse Practitioner | ARNP1351702 | FL |
Practice location
520 A1a N Ste 101Ponte Vedra Beach, FL 32082-2260
Phone 904-273-6900 · Fax 904-390-7479
Mailing address
Po Box 746638Atlanta, GA 30374-6638
Phone 904-202-1032 · Fax 904-376-4107
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 14 Nurse Practitioner providers in Ponte Vedra Beach · All 678 providers in Ponte Vedra Beach
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