Individual
MARDIS H HARRELL
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
928 MAR WALT DR, SUITE 201, FORT WALTON BEACH, FL 32547-6706
(850) 862-4377
(850) 862-6015
Mailing address
123 CLIFFORD DR, SHALIMAR, FL 32579-1251
(850) 651-5313
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
ARNP 2135062
FL
Other
Enumeration date
08/11/2005
Last updated
07/08/2007
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