Provider Demographics
NPI:1497140982
Name:HARRIS, QUIANNA RASHIDA
Entity Type:Individual
Prefix:
First Name:QUIANNA
Middle Name:RASHIDA
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 1:327 N ROSS ST APT 222
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-8870
Mailing Address - Country:US
Mailing Address - Phone:850-723-5010
Mailing Address - Fax:
Practice Address - Street 1:327 N ROSS ST APT 222
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-8870
Practice Address - Country:US
Practice Address - Phone:850-723-5010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-01
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS10759390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program