Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208G00000X | Cardiothoracic Vascular Surgeon | 24530 | MS |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 54337 | TN |
NPI | 1104056555 |
---|---|
Provider Name | Rachel E. Harrison |
First Address | Memphis, TN 38120-2112 |
Second Address | Memphis, TN 38120-2112 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2009 |
Last Update Date | 16/09/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
103I782623 | MEDICARE PROVIDER TRANSACTION ACCESS NUMBER (01) | TN |
3713059 | MEDICARE GROUP PTAN (01) | TN |