Provider Demographics
NPI:1396253282
Name:HARRIS, BELINDA
Entity type:Individual
Prefix:
First Name:BELINDA
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6203 TIMBERLAND CT
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46221-4554
Mailing Address - Country:US
Mailing Address - Phone:404-374-8991
Mailing Address - Fax:
Practice Address - Street 1:4923 ROCKVILLE RD LOT 1
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46224-9140
Practice Address - Country:US
Practice Address - Phone:404-374-8991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-14
Last Update Date:2018-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver