Individual
KENYETTA HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
132 THE MEADOWS DR, CENTRE HALL, PA 16828-9231
(814) 634-2161
Mailing address
810 E WATER ST # 812, APT:20, LOCK HAVEN, PA 17745-1530
(267) 629-1372
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA057725
PA
Other
Enumeration date
08/06/2015
Last updated
08/06/2015
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