Individual
AMANDA HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
7311 STATE HIGHWAY 5, SAINT JOHNSVILLE, NY 13452-4203
(315) 717-7124
Mailing address
7311 STATE HIGHWAY 5, SAINT JOHNSVILLE, NY 13452-4203
(315) 717-7124
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2999151
NY
Other
Enumeration date
01/06/2010
Last updated
01/06/2010
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