Individual
BREANNA HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1714 STATE HIGHWAY 22 W, DARDANELLE, AR 72834-2907
(479) 477-3084
(479) 477-3098
Mailing address
1714 STATE HIGHWAY 22 W, DARDANELLE, AR 72834-2907
(479) 477-3084
(479) 477-3098
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
207Q00000X
Family Medicine Physician
Primary
E-17639
AR
208D00000X
General Practice Physician
U1681
TX
390200000X
Student in an Organized Health Care Education/Training Program
BP10075205
TX
Other
Enumeration date
12/18/2013
Last updated
06/18/2024
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