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Individual

RENEE HARRIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
9857 GIBSON AVE, JACKSONVILLE, FL 32208-1213
(904) 768-1283
Mailing address
9857 GIBSON AVE, JACKSONVILLE, FL 32208-1213
(904) 768-1283

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
9014
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6872336
FL
Enumeration date
06/24/2014
Last updated
06/24/2014
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