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Individual

JOHANNA LYNN HARRIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
2944 BRECKENRIDGE LN, LOUISVILLE, KY 40220-1409
(502) 893-0159
Mailing address
2944 BRECKENRIDGE LN, LOUISVILLE, KY 40220-1409
(502) 893-0159

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3011519
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300007363
IN
05
7100487900
KY
Enumeration date
07/21/2017
Last updated
11/15/2022
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