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Individual
JEANETTE HARRIS
Active
Individual
JEANETTE HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
041372445
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
897709
IEIN
IL
Enumeration date
08/23/2016
Last updated
08/23/2016
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