Provider Demographics
NPI:1629328885
Name:HARRIS, KELLAN SHENTON (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:KELLAN
Middle Name:SHENTON
Last Name:HARRIS
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:2900 12TH AVE N
Mailing Address - Street 2:STE 400E
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-7506
Mailing Address - Country:US
Mailing Address - Phone:406-238-6820
Mailing Address - Fax:406-238-6838
Practice Address - Street 1:2900 12TH AVE N
Practice Address - Street 2:STE 400E
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-7506
Practice Address - Country:US
Practice Address - Phone:406-238-6820
Practice Address - Fax:406-238-6838
Is Sole Proprietor?:No
Enumeration Date:2012-09-14
Last Update Date:2014-04-15
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical