Doctor Name: | KRISTEN HARRIS |
NPI Number: | 1477957645 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | RN213678 |
Business Practice Address: | 819 Church St Royston, GA - 306624434 |
Business Phone Number: | 7062456177 |
Business Fax Number: | 7062456242 |
Mailing Address: | 819 Church St, ROYSTON |
State: | GA |
Postal Code: | 306624434 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 10/17/2014 |
NPI Last Update Date: | 10/17/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | RN213678 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |