Provider Demographics
NPI:1790136323
Name:HARRIS, KAYLEIGH MICHELLE (PA-C)
Entity Type:Individual
Prefix:
First Name:KAYLEIGH
Middle Name:MICHELLE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:1143 NW 64TH TER
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-4218
Mailing Address - Country:US
Mailing Address - Phone:352-331-1201
Mailing Address - Fax:352-331-5273
Practice Address - Street 1:1143 NW 64TH TER
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-4218
Practice Address - Country:US
Practice Address - Phone:352-331-1201
Practice Address - Fax:352-331-5273
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-24
Last Update Date:2016-06-24
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical