Individual
GINA L HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
404 N KEENE ST, SUITE 301, COLUMBIA, MO 65201-6626
(573) 499-6084
(573) 499-6088
Mailing address
PO BOX 843966, KANSAS CITY, MO 64184-3966
(573) 884-3300
(573) 884-0943
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
RN091360
MO
363LW0102X
Women's Health Nurse Practitioner
Primary
091360
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
132709
BLUE SHIELD/BLUE CHOICE
MO
05
—
425202207
—
MO
01
—
4287218101
KANSAS MEDICAID
KS
01
—
446031
HEALTHLINK
MO
01
—
890000729
RR MEDICARE
MO
Enumeration date
05/04/2006
Last updated
08/23/2022
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