Provider Demographics
NPI:1851038038
Name:HARRIS, FONDA SHERRIE (RN)
Entity Type:Individual
Prefix:MRS
First Name:FONDA
Middle Name:SHERRIE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2442 GRACES RUN RD
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45697-9404
Mailing Address - Country:US
Mailing Address - Phone:937-217-8882
Mailing Address - Fax:
Practice Address - Street 1:2442 GRACES RUN RD
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:OH
Practice Address - Zip Code:45697-9404
Practice Address - Country:US
Practice Address - Phone:937-217-8882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-18
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program