Provider Demographics
NPI:1114275948
Name:HARRIS, SETH E (LPN)
Entity Type:Individual
Prefix:MR
First Name:SETH
Middle Name:E
Last Name:HARRIS
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 PARK STREET
Mailing Address - Street 2:
Mailing Address - City:WHEELERSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45694
Mailing Address - Country:US
Mailing Address - Phone:740-357-0106
Mailing Address - Fax:
Practice Address - Street 1:164 PARK ST
Practice Address - Street 2:
Practice Address - City:WHEELERSBURG
Practice Address - State:OH
Practice Address - Zip Code:45694
Practice Address - Country:US
Practice Address - Phone:740-357-0106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-28
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH144309164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse