Bandusch Harris, Karen Jane

Bandusch Harris, Karen Jane is an individual health care provider with primary practice located at 405 Kays Drive , Normal IL 61761. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Bandusch Harris, Karen Jane can be contacted via phone (309) 862-0064.

Contact Information

Primary practice address
405 Kays Drive Normal IL 61761
Phone: (309) 862-0064
Fax: (309) 862-1542
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 085 000712 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 085-000712 Illinois

Profile Details

NPI number 1003994104
LBN Legal business name Bandusch Harris, Karen Jane
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 2nd, 2006
Last updated Jan 15th, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003994104 NPPES
Other 084278 HEALTH ALLIANCE
Other 588330 HEALTH ALLIANCE
Other 5723204 HEALTH ALLIANCE
MEDICAID 588330 HEALTH ALLIANCE
Other CK5970 HEALTH ALLIANCE

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