Individual
MRS. MILDRED HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ADMINISTRATOR
Contact information
Practice address
834 HWY 101, BEAUFORT, NC 28516-7717
(252) 728-6525
Mailing address
834 HWY 101, BEAUFORT, NC 28516-7717
(252) 728-7490
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
FCL016-013
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7803990
—
NC
Enumeration date
08/23/2007
Last updated
06/23/2008
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