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General NPI Number Information
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NPI Number | 1194801605
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Entity Type | Individual
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Provider Name | NEDRA J HARRISON MD FACS
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Gender | Female
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Dates
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Enumeration Date | 10/27/2006
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Last Update Date | 10/28/2020
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Provider Practice Location Address
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Address Line | 9220 E MOUNTAIN VIEW RD STE 102
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-5134
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Country | US
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Telephone | 480-470-6888
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Fax | 833-640-8848
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Provider Business Mailing Address
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Address Line | PO BOX 39179
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City | PHOENIX
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State | AZ
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Zip | 85069-9179
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Country | US
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Telephone | 602-395-0718
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Fax | 602-277-8146
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 28264
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License Number State | AZ
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