Individual
SCOTT W HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.R.N.A.
Contact information
Practice address
5000 MEMORIAL DR, TWO RIVERS, WI 54241-3900
(920) 794-5000
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
140025-030
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051052
CRNA RECERTIFICATION CARD
—
05
—
44308800
—
WI
Enumeration date
12/13/2005
Last updated
05/30/2023
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