Individual
MRS. JACQULENE HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1412 N 2ND ST, ATCHISON, KS 66002-1203
(913) 367-4879
(913) 367-0240
Mailing address
1412 N 2ND ST, ATCHISON, KS 66002-1203
(913) 367-4879
(913) 367-0240
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
45573
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201072810A
—
KS
Enumeration date
05/24/2007
Last updated
01/07/2019
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