Provider Demographics
NPI:1467625376
Name:HARRIS, ELNORA KENDRICK
Entity Type:Individual
Prefix:MRS
First Name:ELNORA
Middle Name:KENDRICK
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 1:8 GROVE SQ
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-4028
Mailing Address - Country:US
Mailing Address - Phone:781-986-9933
Mailing Address - Fax:
Practice Address - Street 1:8 GROVE SQ
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368-4028
Practice Address - Country:US
Practice Address - Phone:781-986-9933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-11
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA66932164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse