Provider Demographics
NPI:1952513251
Name:HARRIS, MARY ELIZABETH (RNC BS)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:ELIZABETH
Last Name:HARRIS
Suffix:
Gender:F
Credentials:RNC BS
Other - Prefix:MRS
Other - First Name:MARY
Other - Middle Name:CROWLEY
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RNC BS
Mailing Address - Street 1:6436 LAWNTON STREET
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19128
Mailing Address - Country:US
Mailing Address - Phone:215-483-3327
Mailing Address - Fax:
Practice Address - Street 1:101 NORTH MERION AVENUE
Practice Address - Street 2:BRYN MAWR COLLEGE HEALTH CENTER
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-2899
Practice Address - Country:US
Practice Address - Phone:610-526-7360
Practice Address - Fax:610-526-7365
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN222361L163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse