Most Relevant Information
Provider Data
| NPI Number: | 1003041617 |
| Provider Name: | KIMBERLY DAWN HARRIS CRNA |
| Entity Type: | Individual |
| Taxonomy Code: | 367500000X |
| Specialty: | Nurse Anesthetist, Certified Registered |
| License Number: | 4704169677 |
Most Important Dates
| Enumeration Date: | 05/27/2009 |
| Last Updated: | 06/28/2010 |
Provider Practice Location
3990 JOHN R ST
DETROIT
MI
482012018
Practice Location Phone/Fax
| Phone: | 3137458521 |
| Fax: |
Provider Mailing Location
PO BOX 67000
DEPT 203401
DETROIT
MI
482670002
Provider Mailing Phone/Fax
| Phone: | 8882784126 |
| Fax: |