Provider Demographics
NPI:1275082711
Name:HARRIS, JANA RAE (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:JANA
Middle Name:RAE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11847 JACKSON CIR
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80233-1627
Mailing Address - Country:US
Mailing Address - Phone:303-452-8151
Mailing Address - Fax:
Practice Address - Street 1:11847 JACKSON CIR
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80233-1627
Practice Address - Country:US
Practice Address - Phone:303-452-8151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-26
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPHA0018427183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist