Provider Demographics
NPI:1053883561
Name:GARRIS, KEVIN FRANKLIN (FNP-C)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:FRANKLIN
Last Name:GARRIS
Suffix:
Gender:
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 1:24B CAMDEN BYP
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:AL
Mailing Address - Zip Code:36726-1770
Mailing Address - Country:US
Mailing Address - Phone:334-882-1919
Mailing Address - Fax:
Practice Address - Street 1:218 MAIN STREET
Practice Address - Street 2:
Practice Address - City:FULTON
Practice Address - State:AL
Practice Address - Zip Code:36446
Practice Address - Country:US
Practice Address - Phone:334-636-4823
Practice Address - Fax:334-636-1702
Is Sole Proprietor?:No
Enumeration Date:2018-12-21
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS903078363LF0000X
AL1-174834363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily