Provider Demographics
NPI:1922898162
Name:HARRISON, AMELIA SHANELL (APRN, AGACNP-BC)
Entity type:Individual
Prefix:
First Name:AMELIA
Middle Name:SHANELL
Last Name:HARRISON
Suffix:
Gender:F
Credentials:APRN, AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 510
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:75949-0510
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1917 ASHLAND ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-3907
Practice Address - Country:US
Practice Address - Phone:281-475-5921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-10
Last Update Date:2025-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1195567363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care