Provider Demographics
NPI:1033581681
Name:HARRIS, CATRINA
Entity Type:Individual
Prefix:DR
First Name:CATRINA
Middle Name:
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 1:233 PEARLIE OWENS DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39212-3273
Mailing Address - Country:US
Mailing Address - Phone:601-750-6818
Mailing Address - Fax:866-753-8145
Practice Address - Street 1:233 PEARLIE OWENS DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39212-3273
Practice Address - Country:US
Practice Address - Phone:601-750-6818
Practice Address - Fax:866-753-8145
Is Sole Proprietor?:No
Enumeration Date:2015-10-22
Last Update Date:2015-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-09567183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist