Individual
JEREL KEITH HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
1677 ARCHER ESTATES DR NW, KENNESAW, GA 30152-8101
(478) 228-8506
Mailing address
1677 ARCHER ESTATES DR NW, KENNESAW, GA 30152-8101
(478) 228-8506
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
RN165803
GA
363LF0000X
Family Nurse Practitioner
Primary
RN165803
GA
Other
Enumeration date
04/06/2019
Last updated
03/10/2026
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