Individual
MARK TODD HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
1505 S 7TH ST, LOUISVILLE, KY 40208-1710
(502) 637-1005
Mailing address
1529 TEXAS AVE, LOUISVILLE, KY 40217-2237
(502) 718-5101
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3009449
KY
Other
Enumeration date
07/03/2015
Last updated
07/03/2015
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