Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 04-37487 | KS |
N | 208000000X | Pediatrician | 2014029657 | MO |
N | 2080P0216X | Pediatric Rheumatologist | 0437487 | KS |
Y | 2080P0216X | Pediatric Rheumatologist | 2014029657 | MO |
NPI | 1558527317 |
---|---|
Provider Name | Dr. Julia Grace Harris |
First Address | Kansas City, MO 64108-4619 |
Second Address | Kansas City, MO 64108-4619 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2008 |
Last Update Date | 20/08/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1558527317 | (05) | WI |