Individual
JENNIFER BROOKE HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
225 MEDICAL CENTER DR STE 405, PADUCAH, KY 42003-7914
(270) 441-4750
(270) 441-4770
Mailing address
225 MEDICAL CENTER DR STE 405, PADUCAH, KY 42003-7914
(270) 441-4750
(270) 441-4770
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3007292
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100196050
—
KY
Enumeration date
01/16/2012
Last updated
01/31/2013
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