Provider Demographics
NPI:1760654032
Name:HARRIS, SARA E (CAC)
Entity type:Individual
Prefix:MS
First Name:SARA
Middle Name:E
Last Name:HARRIS
Suffix:
Gender:F
Credentials:CAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 CHIPPEN DALE CIRCLE
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40517-4405
Mailing Address - Country:US
Mailing Address - Phone:859-309-1743
Mailing Address - Fax:
Practice Address - Street 1:296 SOUTHLAND DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-1932
Practice Address - Country:US
Practice Address - Phone:859-402-2430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-27
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYAC040171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist