Provider Demographics
NPI:1235289026
Name:HARRIS, BRIANA LYNN (R)
Entity Type:Individual
Prefix:
First Name:BRIANA
Middle Name:LYNN
Last Name:HARRIS
Suffix:
Gender:F
Credentials:R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 E BUSBEE ST
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:AR
Mailing Address - Zip Code:71701-7303
Mailing Address - Country:US
Mailing Address - Phone:870-574-2158
Mailing Address - Fax:
Practice Address - Street 1:11300 FINANCIAL CENTRE PKWY
Practice Address - Street 2:SUITE 400
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-3746
Practice Address - Country:US
Practice Address - Phone:501-221-2502
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARRTL6787247100000X
3997782471C3402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist
Not Answered2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiography