Provider Demographics
NPI:1023033248
Name:HARRIS, STEPHANIE DENISE
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:DENISE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3731 EL CAMINO ST
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801-8845
Mailing Address - Country:US
Mailing Address - Phone:907-789-0398
Mailing Address - Fax:
Practice Address - Street 1:709 W 9TH ST
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801-1807
Practice Address - Country:US
Practice Address - Phone:907-463-2152
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other