Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | RN426647 | CA |
NPI | 1194946848 |
---|---|
Provider Name | Ms. Felicia Cecilia Harris |
First Address | Moreno Valley, CA 92251-1987 |
Second Address | Paml Springs, CA 92263 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2007 |
Last Update Date | 08/07/2007 |