MENDALOSE ORTEGA HARRIS (NPI# 1093045684) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093045684 |
| Entity Type | Individual |
| Full Name | MENDALOSE ORTEGA HARRIS |
| Credential | RN |
| Practice Address |
300 East Hospital Road Dwight David Eisenhower Army Medical Center Fort Gordon GA 30905-5650 |
| Mailing Address |
38701 38th St Preventative Medicine Building Fort Gordon GA 30905-5650 |
| Practice Telephone | 7067871193 |
| Mailing Telephone | 7067871193 |
| Enumeration Date | 2010-01-05 |
| Last Update Date | 2015-04-14 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WC1500X |
Registered Nurse Specialization: Community Health |
041257023 | IL | Nursing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | ARMY PUBLIC HEALTH NURSE-MILITARY PROVIDER | 041257023 | 01 |
| Street Address |
300 EAST HOSPITAL ROAD DWIGHT DAVID EISENHOWER ARMY MEDICAL CENTER |
| City | FORT GORDON |
| State | GA |
| Zip Code | 30905-5650 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083613665 | Joseph Melton Bird | Social Worker | 300 East Hospital Road, Room 13a-10, Fort Gordon, GA 30905-5650 | 2005-07-18 |
| 1023616224 | Vernon Thomas Traeder Sharp | Student in an Organized Health Care Education/Training Program | 300 East Hospital Road, Fort Gordon, GA 30905-5650 | 2020-10-12 |
| 1740894583 | Stephanie Marie Rice | Student in an Organized Health Care Education/Training Program | 300 East Hospital Road, Fort Gordon, GA 30905 | 2020-08-31 |
| 1710590542 | Kenneth Blind | Student in an Organized Health Care Education/Training Program | 300 East Hospital Road, Fort Gordon, GA 30905-5650 | 2020-08-31 |
| 1467078519 | Joseph Nathaniel Stancampiano | Student in an Organized Health Care Education/Training Program | 300 East Hospital Road, Fort Gordon, GA 30509-5650 | 2020-06-24 |
| 1912523101 | Austin Keith Nokes | Student in an Organized Health Care Education/Training Program | 300 East Hospital Road, Fort Gordon, GA 30905-5650 | 2020-06-23 |
| 1992329940 | Eda Chen | Student in an Organized Health Care Education/Training Program | 300 East Hospital Road, Fort Gordon, GA 30905-5650 | 2020-06-05 |
| 1154945269 | Yiwei Jiao | Student in an Organized Health Care Education/Training Program | 300 East Hospital Road, Fort Gordon, GA 30905-5650 | 2020-06-04 |
| 1942824164 | Camille Lynn | Student in an Organized Health Care Education/Training Program | 300 East Hospital Road, Fort Gordon, GA 30905-5650 | 2020-06-03 |
| 1023632429 | Brandon Lee Myers | Student in an Organized Health Care Education/Training Program | 300 East Hospital Road, Fort Gordon, GA 30905-5650 | 2020-06-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417508995 | Priscilla Denise Brown | Prosthetic/Orthotic Supplier | 38200 3rd Ave, Fort Gordon, GA 30905 | 2019-09-25 |
| 1740754308 | Patricia Lynn Blevins | Nurse Practitioner | 300 E Hospital Dr, Augusta, GA 30905 | 2019-01-17 |
| 1861971335 | Isabella Anderson | Dentist | Usa Dental Activity, Hospital Dental Clinic, Bldg 38801 Academic, Ste B&c, Ft Gordon, GA 30905 | 2018-08-07 |
| 1972097426 | Cortney Wolfley | Student in an Organized Health Care Education/Training Program | Orthopaedics Ddeamc, 300 East Hospital Road, Fort Gordon, GA 30905 | 2018-06-19 |
| 1003337536 | David Jonathon Sabovich | Dentist | 38801 Academic Dr Ste B&cactivity, Suite B & C, Ft Gordon, GA 30905 | 2017-07-06 |
| 1437689411 | Marcos Aranda | Student in an Organized Health Care Education/Training Program | General Surgery, Eisenhower Army Medical Center, 300 East Hospital Road, Fort Gordon, GA 30905 | 2017-06-13 |
| 1659809846 | Brian Kevin Burke | Student in an Organized Health Care Education/Training Program | 300 East Hosptial Road, Fort Gordon, GA 30905 | 2017-06-01 |
| 1902334469 | Jacqueline Renee Mulhall | Student in an Organized Health Care Education/Training Program | Ddeamc, 300 E Hospital Rd, General Surgery, Fort Gordon, GA 30905 | 2017-05-30 |
| 1750837456 | Amanda R Bailey | Internal Medicine | 300 E. Hospital Dr., Fort Gordon, GA 30905 | 2016-09-01 |
| 1689120016 | Thomas S Moffitt | Internal Medicine | Im, Dwight D Eisenhower Army Medical Center, 300 East Hospital Road, Fort Gordon, GA 30905 | 2016-08-26 |
| Find all providers in zip 30905 | ||||
| Taxonomy Code | 163WC1500X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Community Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912393554 | Timothy Williams | Registered Nurse | Building 38701 38th St, Fort Gordon, GA 30905 | 2015-04-10 |
| 1902069701 | Patricia A. Ross | Registered Nurse | 300 W Hospital Road Eisenhower Army Medical Ctr, Attn: Credentials, Fort Gordon, GA 30905-5650 | 2008-07-02 |
| 1912162025 | Maria Carmen Mendez-del Valle | Registered Nurse | 300 W Hospital Rd, Eisenhower Army Medical Center Attn Credentials, Fort Gordon, GA 30905-5741 | 2008-07-29 |
| 1295996221 | Robbiesteene L. Trent | Registered Nurse | 300 W Hospital Rd, Attn: Credentials, Fort Gordon, GA 30905-5741 | 2008-06-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255967071 | Simran Kaur | Registered Nurse | 2252 Nellie Dr, Augusta, GA 30906-8964 | 2020-03-13 |
| 1124651914 | Gyneth Springs Givens | Registered Nurse | 30 Glen Ridge Ct, Covington, GA 30014-6080 | 2020-02-19 |
| 1760021448 | Kenneth Unuovurhaye | Registered Nurse | 2073 Corners Circle Trce, Lithonia, GA 30058-7993 | 2019-12-30 |
| 1063069391 | Mark Benson | Registered Nurse | 4176 Chatford Cv, Tucker, GA 30084-7907 | 2019-08-21 |
| 1508325242 | Yashate Kinkia Pendergrass | Registered Nurse | 2159 Grove Landing Way, Grovetown, GA 30813-7017 | 2019-03-12 |
| 1083196836 | Peta-gaye C Pilote | Registered Nurse | 319 Regal Way E, Mcdonough, GA 30253 | 2018-08-29 |
| 1144701855 | Nadiyah Gardner | Registered Nurse | 1790 Mulkey Rd Ste 3b, Austell, GA 30106-1122 | 2018-08-22 |
| 1205324357 | Lona M Sims | Registered Nurse | 2113 Defoors Ferry Rd Nw Apt F5, Atlanta, GA 30318-2344 | 2018-04-24 |
| 1881108884 | Carol Lee Hadley | Registered Nurse | 10 Park Place South Se Ste 445, Atlanta, GA 30303-2913 | 2017-11-29 |
| 1164940235 | De Advance Home Healthcare Services Inc | Registered Nurse | 932 Landon Dr, Marietta, GA 30064-6421 | 2017-09-08 |
| Find all providers with the same taxonomy | ||||
| City | FORT GORDON |
| Zip Code | 30905 |
Please comment or provide details below to improve the information on MENDALOSE ORTEGA HARRIS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.