Provider Demographics
NPI:1285859124
Name:HARRIS, ELIZABETH RUTH
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:RUTH
Last Name:HARRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BETTYE
Other - Middle Name:RUTH
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:JODIE PARTRIDGE CENTER
Mailing Address - Street 2:PO BOX 643
Mailing Address - City:DUMAS
Mailing Address - State:AR
Mailing Address - Zip Code:71639-0643
Mailing Address - Country:US
Mailing Address - Phone:870-382-4374
Mailing Address - Fax:870-382-6814
Practice Address - Street 1:JODIE PARTRIDGE CENTER
Practice Address - Street 2:1180 HIGHWAY 165
Practice Address - City:DUMAS
Practice Address - State:AR
Practice Address - Zip Code:71639-0643
Practice Address - Country:US
Practice Address - Phone:870-382-4374
Practice Address - Fax:870-382-6814
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator