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General NPI Number Information
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NPI Number | 1518416304
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Entity Type | Individual
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Provider Name | STEPHANIE HARRIS
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Gender | Female
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Dates
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Enumeration Date | 09/22/2016
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 11710 GRIFFING AVE
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City | CLEVELAND
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State | OH
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Zip | 44120-3010
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Country | US
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Telephone | 216-965-6325
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Fax |
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Provider Business Mailing Address
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Address Line | 11811 SHAKER BLVD STE 123
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City | CLEVELAND
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State | OH
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Zip | 44120-1927
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Country | US
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Telephone | 216-242-5990
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Fax | 216-393-3610
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN.CNP.019910
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License Number State | OH
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