Provider Demographics
NPI:1265055362
Name:HARRISON, SYLVIA DEANNA (CNA)
Entity type:Individual
Prefix:
First Name:SYLVIA
Middle Name:DEANNA
Last Name:HARRISON
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3516 LEVEL RD
Mailing Address - Street 2:
Mailing Address - City:CHURCHVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21028-1436
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3516 LEVEL RD
Practice Address - Street 2:
Practice Address - City:CHURCHVILLE
Practice Address - State:MD
Practice Address - Zip Code:21028-1436
Practice Address - Country:US
Practice Address - Phone:443-760-1066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-22
Last Update Date:2020-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide