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General NPI Number Information
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NPI Number | 1962609784
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Entity Type | Individual
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Provider Name | HOLLY BETH HARRISON PA-C
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Gender | Female
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Dates
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Enumeration Date | 06/27/2007
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Last Update Date | 09/08/2022
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Provider Practice Location Address
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Address Line | 503 S 8TH ST
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City | GRIFFIN
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State | GA
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Zip | 30224-4211
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Country | US
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Telephone | 770-227-5505
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Fax | 770-412-7881
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Provider Business Mailing Address
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Address Line | 503 S 8TH ST
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City | GRIFFIN
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State | GA
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Zip | 30224-4211
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Country | US
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Telephone | 770-227-5505
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Fax | 770-412-7881
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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 | 005089
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License Number State | GA
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