Individual
MICHAEL HARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
HWY 264 MILEPOST 388, POLACCA, AZ 86042-4000
(928) 737-6000
Mailing address
8855 NE 150TH ST, FLETCHER, OK 73541-2542
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704196884
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020529
—
AZ
Enumeration date
05/26/2011
Last updated
05/26/2011
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