Individual
DEBRA J HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
300 N MAPLE ST, EFFINGHAM, IL 62401-2003
(217) 342-4151
(217) 342-4190
Mailing address
300 N MAPLE ST, P.O. BOX 1268, EFFINGHAM, IL 62401-2003
(217) 342-4151
(217) 342-4190
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209008065
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209008065
ADVANCE PRACTICE NURSE LICENSE
IL
01
—
37-1329873
EMPLOYER (MARSHALL CLINIC EFFINGHAM, S.C.) TAX ID
IL
01
—
F0210048
AM. ACADEMY OF NURSE PRACTITIONERS CERTIFICATION
IL
Enumeration date
03/05/2010
Last updated
03/05/2010
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