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Individual

ALYSSA M HARRIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1401 HARRODSBURG RD, SUITE A-540, LEXINGTON, KY 40504-3751
(859) 258-6760
(859) 258-6512
Mailing address
1401 HARRODSBURG RD, SUITE A-540, LEXINGTON, KY 40504-3751
(859) 258-6760
(859) 258-6512

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA1598
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100144660
KY
01
PA1598
STATE LICENSURE
KY
Enumeration date
09/30/2010
Last updated
10/10/2013
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