Individual
MS. EBONY ELISE HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1264 GRIGGS ST SE, GRAND RAPIDS, MI 49507-2842
(517) 962-3947
Mailing address
1264 GRIGGS ST SE, GRAND RAPIDS, MI 49507-2842
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703122741
MI
Other
Enumeration date
10/17/2025
Last updated
10/17/2025
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