Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant |
NPI | 1356978712 |
---|---|
Provider Name | Carrie Adele Harris |
First Address | Anchorage, AK 99508-5054 |
Second Address | Anchorage, AK 99508-5054 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2020 |
Last Update Date | 25/03/2020 |