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General NPI Number Information
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NPI Number | 1427182252
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Entity Type | Individual
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Provider Name | MARJORIE ANITA HARRIS RN
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Gender | Female
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 14585 GREENFIELD ROAD DETROIT HEALTH DEPT. - GRACE ROSS HEALTH CENTER
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City | DETROIT
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State | MI
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Zip | 48227
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Country | US
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Telephone | 313-852-4565
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Fax | 313-852-4468
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Provider Business Mailing Address
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Address Line | 20170 CAROL ST
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City | DETROIT
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State | MI
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Zip | 48235-1655
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Country | US
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Telephone | 313-864-8978
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Fax | 313-852-4468
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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 | 163WA2000X
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Taxonomy Name | Administrator Registered Nurse
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License Number | 4704119140
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License Number State | MI
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