Provider Demographics
NPI:1053889519
Name:HARRIS, JAYME
Entity type:Individual
Prefix:
First Name:JAYME
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5926 CULZEAN DR APT 615
Mailing Address - Street 2:
Mailing Address - City:TROTWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45426-1252
Mailing Address - Country:US
Mailing Address - Phone:937-238-5054
Mailing Address - Fax:
Practice Address - Street 1:5926 CULZEAN DR APT 615
Practice Address - Street 2:
Practice Address - City:TROTWOOD
Practice Address - State:OH
Practice Address - Zip Code:45426-1252
Practice Address - Country:US
Practice Address - Phone:937-238-5054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-02
Last Update Date:2018-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health