Provider Demographics
NPI:1487261574
Name:HARRIS, ERICA SUZANNE (PHARMACIST)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:SUZANNE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1997 BUFFALO TRL
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37814-4364
Mailing Address - Country:US
Mailing Address - Phone:423-254-6595
Mailing Address - Fax:
Practice Address - Street 1:1997 BUFFALO TRL
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37814-4364
Practice Address - Country:US
Practice Address - Phone:423-254-6595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-23
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN44369183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist