Individual
NICOSHA SHANAE HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
704 W NATIONAL AVE APT 140, MILWAUKEE, WI 53204-1742
(414) 243-6647
Mailing address
704 W NATIONAL AVE APT 140, MILWAUKEE, WI 53204-1742
(414) 243-6647
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
261QC1500X
Community Health Clinic/Center
Primary
—
—
376K00000X
Nurse's Aide
—
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/15/2022
Last updated
07/15/2022
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