Harris, Mendalose Ortega
Harris, Mendalose Ortega is an sole proprietor health care provider with primary practice located at 300 East Hospital Road Dwight David Eisenhower Army Medical Center, Fort Gordon GA 30905-5650. She recently has only one registered license in Nursing Service Providers / Community Health, which is considered as her primary health care specialty. Harris, Mendalose Ortega can be contacted via phone (706) 787-1193.Contact Information
Primary practice address
300 East Hospital Road Dwight David Eisenhower Army Medical Center
Fort Gordon GA 30905-5650
Phone: (706) 787-1193
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing Service Providers / Community Health | 163WC1500X | 041257023 | Illinois |
Profile Details
| NPI number | 1093045684 |
|---|---|
| LBN Legal business name | Harris, Mendalose Ortega |
| Credentials | Registered Nurse (RN) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 5th, 2010 |
| Last updated | Apr 14th, 2015 - about 9 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1093045684 | NPPES |
| Illinois | Other | 041257023 | ARMY PUBLIC HEALTH NURSE-MILITARY PROVIDER |
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