Provider Demographics
NPI:1740690759
Name:HARRIS, KATHERINE (DO)
Entity type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:150 MARKET RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:DALEVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24083-3258
Mailing Address - Country:US
Mailing Address - Phone:540-966-0400
Mailing Address - Fax:540-992-6669
Practice Address - Street 1:150 MARKET RIDGE LN
Practice Address - Street 2:
Practice Address - City:DALEVILLE
Practice Address - State:VA
Practice Address - Zip Code:24083-3258
Practice Address - Country:US
Practice Address - Phone:540-966-0400
Practice Address - Fax:540-992-6669
Is Sole Proprietor?:No
Enumeration Date:2014-04-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102204754207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine