Provider Demographics
NPI:1174688782
Name:HARRIS, JANET R (PHD RN)
Entity Type:Individual
Prefix:DR
First Name:JANET
Middle Name:R
Last Name:HARRIS
Suffix:
Gender:F
Credentials:PHD RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17529 TIMBERLEIGH WAY
Mailing Address - Street 2:
Mailing Address - City:WOODBINE
Mailing Address - State:MD
Mailing Address - Zip Code:21797-7928
Mailing Address - Country:US
Mailing Address - Phone:210-258-8540
Mailing Address - Fax:
Practice Address - Street 1:1077 PATCHELL ST
Practice Address - Street 2:
Practice Address - City:FORT DETRICK
Practice Address - State:MD
Practice Address - Zip Code:21702-9244
Practice Address - Country:US
Practice Address - Phone:301-619-7073
Practice Address - Fax:301-619-7796
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE31130163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse