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General NPI Number Information
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NPI Number | 1679687412
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Entity Type | Organization
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Legal Business Name | HARRIS HEALTHCARE LLC
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Dates
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Enumeration Date | 08/18/2006
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Last Update Date | 02/02/2015
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Provider Practice Location Address
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Address Line | 7348 W. 21ST ST N SUITE 107
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City | WICHITA
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State | KS
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Zip | 67205-1765
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Country | US
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Telephone | 316-721-4828
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Fax | 316-721-4844
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Provider Business Mailing Address
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Address Line | 7348 W. 21ST ST N. SUITE 107
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City | WICHITA
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State | KS
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Zip | 67205-1765
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Country | US
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Telephone | 316-721-4828
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Fax | 316-721-4844
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Authorized Official
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Title or Position | OWNER
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Name | MRS. JUDITH KAY HARRIS
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Credential | APRN
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Telephone | 316-721-4828
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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 |
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License Number State |
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