Individual
SOPOURIA KEYSHUN HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4500 AUTUMN WOODS WAY, TALLAHASSEE, FL 32303-6935
(850) 491-8969
Mailing address
4500 AUTUMN WOODS WAY, TALLAHASSEE, FL 32303-6935
(850) 491-8969
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5213118
FL
Other
Enumeration date
08/18/2017
Last updated
07/21/2022
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