Individual
MRS. MARLENA JO HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN,APRN,BC,CRNA
Contact information
Practice address
128 1/2 EAST POINT DRIVE, CHARLESTON, WV 25311
(304) 925-2266
Mailing address
3200 MACCORKLE AVE SE, CAMC, CHARLESTON, WV 25304-1227
(304) 388-6220
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
42882
WV
367500000X
Certified Registered Nurse Anesthetist
Primary
42882
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810001280
—
WV
Enumeration date
05/04/2006
Last updated
10/13/2009
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