NICOLE WIRTH HARRY PMHNP-BC NPI 1063234037

NPI Information

  • NPI: 1063234037
  • Provider Name: NICOLE WIRTH HARRY, PMHNP-BC
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1703 COUNTRY CLUB RD
    SUITE 204
    JACKSONVILLE, NC
    ZIP 28546
  • Phone: (910) 347-3010

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NPI Details

Nicole Wirth Harry, PMHNP-BC is a psychiatric/mental health nurse practitioner in Jacksonville, NC with 2 years of experience. Nicole Wirth Harry, PMHNP-BC NPI is 1063234037. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1703 COUNTRY CLUB RD
SUITE 204
JACKSONVILLE, NC
ZIP 28546
Phone: (910) 347-3010

The NPI 1063234037 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/30/2024 and was last updated on 10/30/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0808XNurse PractitionerPsychiatric/Mental Health5021083NORTH CAROLINAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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