Individual
EDLISA HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
4500 BRENTWOOD STAIR RD APT 1131, FORT WORTH, TX 76103-1621
(469) 855-1519
Mailing address
4500 BRENTWOOD STAIR RD APT 1131, FORT WORTH, TX 76103-1621
(469) 855-1519
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
350925
TX
Other
Enumeration date
09/14/2020
Last updated
09/14/2020
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