Basic Information
| Provider Information | |||||||||
| NPI: | 1366030850 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HARRIS | ||||||||
| FirstName: | ELIZABETH | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 50 E MAIN ST | ||||||||
| Address2: | |||||||||
| City: | JEROMESVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 448409663 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4196850603 | ||||||||
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| Practice Location | |||||||||
| Address1: | 400 TUSCARAWAS ST W STE 200 | ||||||||
| Address2: | |||||||||
| City: | CANTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 447022044 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3304382400 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/09/2021 | ||||||||
| LastUpdateDate: | 02/20/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/20/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | APRN.CNP.0028321 | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.