Harris, Kerry Shawn

Harris, Kerry Shawn is an individual health care provider with primary practice located at 4351 E Lohman Ave Ste 320 , Las Cruces NM 88011-8262. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is his primary health care specialty. Harris, Kerry Shawn can be contacted via phone (575) 522-0116.

Contact Information

Primary practice address
4351 E Lohman Ave Ste 320 Las Cruces NM 88011-8262
Phone: (575) 522-0116
Fax: (575) 522-0094
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 364SA2200X CNS-00220 New Mexico
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X CNP-54594 New Mexico

Profile Details

NPI number 1164738399
LBN Legal business name Harris, Kerry Shawn
Credentials Certified Nurse Practitioner (CNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 25th, 2010
Last updated Sep 9th, 2020 - about 4 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 1164738399 NPPES
New Mexico MEDICAID 95135791
New Mexico Other 407592YY54

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