Provider Demographics
NPI:1346363256
Name:HARRIS, DONNA LEWICE
Entity Type:Individual
Prefix:MISS
First Name:DONNA
Middle Name:LEWICE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 S 7TH ST
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42003-1825
Mailing Address - Country:US
Mailing Address - Phone:270-442-1256
Mailing Address - Fax:
Practice Address - Street 1:803 POPLAR STREET
Practice Address - Street 2:MURRAY -CALLOWAY COUNTY HOSPITAL
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071
Practice Address - Country:US
Practice Address - Phone:270-762-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYAO216174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist