| Doctor Name: | MRS. JACQULENE HARRIS |
| NPI Number: | 1538370291 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | 45573 |
| Business Practice Address: | 702 N 3rd St Atchison, KS - 660021919 |
| Business Phone Number: | 9133607456 |
| Business Fax Number: | 8162335296 |
| Mailing Address: | 702 N 3rd St, ATCHISON |
| State: | KS |
| Postal Code: | 660021919 |
| Phone Number: | 9133607456 |
| Fax Number: | 8162335296 |
| NPI Enumeration Date: | 05/24/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 45573 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KS |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |