Individual
MRS. LISA M HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.C.
Contact information
Practice address
2131 N RIDGE RD, WICHITA, KS 67212-1570
(316) 773-1212
(316) 729-1385
Mailing address
2131 N RIDGE RD, STE 101, WICHITA, KS 67212-1571
(316) 648-1157
(316) 440-6601
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1500851
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100424600C
—
KS
01
—
426809
BCBS
KS
Enumeration date
05/13/2006
Last updated
09/28/2022
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