Doctor Name: | JACQUELINE K HARRIS |
NPI Number: | 1962485813 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ARNP |
License Number: | A093734 |
Business Practice Address: | 101 W Washington St Montezuma, IA - 501717739 |
Business Phone Number: | 6416235690 |
Business Fax Number: | |
Mailing Address: | Po Box 430, MONTEZUMA |
State: | IA |
Postal Code: | 501710430 |
Phone Number: | 6416235690 |
Fax Number: | |
NPI Enumeration Date: | 11/23/2005 |
NPI Last Update Date: | 02/06/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2100X |
License Number: | A093734 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Acute Care |
Taxonomy Definition: |