Individual
COURTNEY J HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1 SAINT ELIZABETH BLVD, O FALLON, IL 62269-1099
(618) 234-2120
(618) 641-5810
Mailing address
319 N OAKCREST AVE, DECATUR, IL 62522-1812
(314) 616-5191
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209.020870
IL
Other
Enumeration date
03/10/2020
Last updated
04/17/2020
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