Individual
STACY HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
HOME CARE AGENCY
Contact information
Practice address
900 S ARLINGTON AVE RM 144B, HARRISBURG, PA 17109-5030
(717) 370-4976
(717) 412-7390
Mailing address
900 S ARLINGTON AVE RM 144B, HARRISBURG, PA 17109-5030
(717) 370-4976
(717) 412-7390
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
11793601
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
455288227
—
PA
Enumeration date
03/18/2020
Last updated
03/18/2020
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