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Individual

MARY E HARRISON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
330 PASEO DEL PUEBLO SUR, UNIT C, TAOS, NM 87571-5219
(505) 758-1414
Mailing address
3600 RODEO LN, STE A-1, SANTA FE, NM 87507-6400
(505) 216-3615

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CNP00253
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
74867
NM
Enumeration date
07/05/2006
Last updated
04/26/2013
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