Harris, Martha

Harris, Martha is an individual health care provider with primary practice located at 311 W Lincoln St Suite 201, Belleville IL 62220-1902. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Harris, Martha can be contacted via phone (618) 222-3200.

Contact Information

Primary practice address
311 W Lincoln St Suite 201 Belleville IL 62220-1902
Phone: (618) 222-3200
Fax: (618) 222-3203
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 94978 Missouri

Profile Details

NPI number 1841241676
LBN Legal business name Harris, Martha
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date May 15th, 2006
Last updated Mar 3rd, 2017 - about 8 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 1841241676 NPPES
Missouri MEDICAID 915102420

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