Healthcare Provider Details

I. General information

NPI: 1609788686
Provider Name (Legal Business Name): KAIA HARRISON PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 COLLEGE BACKBONE RD
PRINCESS ANNE MD
21853-6000
US

IV. Provider business mailing address

532 ALABAMA AVE APT D
SALISBURY MD
21801-5789
US

V. Phone/Fax

Practice location:
  • Phone: 410-621-3658
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number0202222175
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: