Individual
JAMES KENNETH HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
425 PINE RIDGE BLVD, WAUSAU, WI 54401-4123
(715) 845-5055
Mailing address
3699 LAURIE ANN LN, WAUSAU, WI 54401-8401
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
118453
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
118453
NBCRNA
WI
Enumeration date
09/01/2017
Last updated
09/01/2017
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