Most Relevant Information
Provider Data
| NPI Number: | 1003409285 |
| Provider Name: | KATHRYN HARRELL |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/18/2021 |
| Last Updated: | 02/18/2021 |
Provider Practice Location
1500 S AVE K
STATION 3, SHROC
PORTALES
NM
88130
Practice Location Phone/Fax
| Phone: | 5755622160 |
| Fax: |
Provider Mailing Location
1500 S AVE K
STATION 3, SHROC
PORTALES
NM
88130
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |