Provider Demographics
NPI:1174808059
Name:HARRIS, STEPHANIE E (PA-C)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:E
Last Name:HARRIS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1350 CONNECTICUT AVE NW
Mailing Address - Street 2:SUITE 1250
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-1722
Mailing Address - Country:US
Mailing Address - Phone:202-627-1901
Mailing Address - Fax:202-660-0025
Practice Address - Street 1:1350 CONNECTICUT AVE NW
Practice Address - Street 2:SUITE 1250
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-1722
Practice Address - Country:US
Practice Address - Phone:202-627-1901
Practice Address - Fax:415-252-7176
Is Sole Proprietor?:No
Enumeration Date:2011-10-11
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DCPA030791363AM0700X
GA9863363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant