Healthcare Provider Details

I. General information

NPI: 1972853273
Provider Name (Legal Business Name): JANET LYNN HARRIS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/13/2012
Last Update Date: 05/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6848 TARAWA DR
CINCINNATI OH
45224-1100
US

IV. Provider business mailing address

6848 TARAWA DR
CINCINNATI OH
45224-1100
US

V. Phone/Fax

Practice location:
  • Phone: 513-407-7688
  • Fax: 513-407-7688
Mailing address:
  • Phone: 513-407-7688
  • Fax: 513-407-7688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberRN-184214
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: