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Individual

KERRY SHAWN HARRIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CNP

Contact information

Practice address
4351 E LOHMAN AVE STE 320, LAS CRUCES, NM 88011-8262
(575) 522-0116
(575) 522-0094
Mailing address
4351 E LOHMAN AVE STE 320, LAS CRUCES, NM 88011-8262
(575) 522-0116
(575) 522-0094

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CNP-54594
NM
364SA2200X
Adult Health Clinical Nurse Specialist
CNS-00220
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
407592YY54
MEDICARE PTAN
NM
05
95135791
NM
Enumeration date
08/25/2010
Last updated
09/09/2020
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