Individual
MRS. SHANNA TOMIKO HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
0024166858
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010254426
—
VA
01
—
10007294N
OPTIMA HEALTH
VA
Enumeration date
07/11/2006
Last updated
11/21/2012
Update your record
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