Provider Demographics
NPI:1366535411
Name:HARRISON, MISTY (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:MISTY
Middle Name:
Last Name:HARRISON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 LANCELOT RD
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79602-4243
Mailing Address - Country:US
Mailing Address - Phone:325-670-9449
Mailing Address - Fax:325-793-9820
Practice Address - Street 1:1305 LANCELOT RD
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79602-4243
Practice Address - Country:US
Practice Address - Phone:325-670-9449
Practice Address - Fax:325-793-9820
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX603617363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily