Individual
MRS. ILA GERTRUDE HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1017 HWY 158, ROUGEMONT, NC 27572
(919) 693-7591
Mailing address
1017 HWY 158, ROUGEMONT, NC 27572
(919) 693-7591
Taxonomy
Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary
FCL-039-002
NC
Other
Enumeration date
05/29/2007
Last updated
07/08/2007
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