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General NPI Number Information
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NPI Number | 1114793221
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Entity Type | Individual
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Provider Name | KIRSTI HARRIS
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Gender | Female
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Dates
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Enumeration Date | 11/29/2023
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Last Update Date | 08/02/2024
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Provider Practice Location Address
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Address Line | 2818 NEUSE BLVD
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City | NEW BERN
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State | NC
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Zip | 28562-2850
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Country | US
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Telephone | 252-636-4920
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Fax |
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Provider Business Mailing Address
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Address Line | 1413 COMET DR
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City | NEW BERN
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State | NC
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Zip | 28562-1108
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Country | US
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Telephone | 850-557-0643
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA.2330
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License Number State | AL
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