Individual
JEANETTE NECOLE HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
IDMT
Contact information
Practice address
1381 S PATRICK DR, PATRICK AFB, FL 32925-3606
(321) 494-8191
Mailing address
3016 SAVANNAH WAY APT 202, MELBOURNE, FL 32935-3639
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
09/21/2010
Last updated
09/21/2010
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