Individual
MR. JONATHAN LEE HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
789 CENTRAL AVE, DOVER, NH 03820-2526
(603) 742-5252
Mailing address
3998 FAIR RIDGE DR, SUITE 300, FAIRFAX, VA 22033-2907
(703) 295-9360
(703) 766-9725
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0447722311
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30342007
—
NH
Enumeration date
08/11/2005
Last updated
04/24/2015
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