Individual
JARED SCOTT HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12266 DE PAUL DR STE 205, BRIDGETON, MO 63044-2514
(314) 218-2300
Mailing address
12266 DE PAUL DR STE 205, BRIDGETON, MO 63044-2514
(314) 218-2300
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2018022439
MO
363LF0000X
Family Nurse Practitioner
Primary
2024014974
MO
Other
Enumeration date
10/14/2024
Last updated
10/14/2024
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