MEDICARE: HEATHER RAE HARRIS PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	15485	NE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	15485	OTHER	NE	NEBRASKA BOARD OF PHARMACY

General Provider Information

NPI Number	:	1659860773
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER RAE HARRIS PHARMD

Provider Business Mailing Address
First Line	:	317 N WEBSTER ST
Second Line	:
City	:	RED CLOUD
State	:	NE
Zip	:	68970-2549
Country	:	US
Telephone Number	:	402-746-3335
Fax Number	:	402-746-3355

Provider Business Practice Location Address
First Line	:	317 N WEBSTER ST
Second Line	:
City	:	RED CLOUD
State	:	NE
Zip	:	68970-2549
Country	:	US
Telephone Number	:	402-746-3335
Fax Number	:	402-746-3355

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2018
Last Update Date	:	05/03/2018

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Directions to “ HEATHER RAE HARRIS PHARMD” Practice Location

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