Individual
KENAN HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
9300 W SUNSET RD, LAS VEGAS, NV 89148-4844
(702) 916-5000
Mailing address
PO BOX 100744, ATLANTA, GA 30384-4356
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1741
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093772204
—
NV
Enumeration date
05/04/2016
Last updated
04/24/2024
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