Individual
JESSICA HARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1201 MAIN AVE, SUITE 203, DURANGO, CO 81301-5260
(970) 403-0555
(970) 403-0556
Mailing address
PO BOX 2487, DURANGO, CO 81302-2487
(970) 403-0555
(970) 403-0556
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3179
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3179
COLORADO LICENSE
CO
Enumeration date
05/02/2011
Last updated
05/02/2011
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