| Mary D Harris, | |
|
9685 Chillicothe Rd, Kirtland, OH 44094-8503 | |
| (440) 256-8100 | |
| Not Available |
| Full Name | Mary D Harris |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 9685 Chillicothe Rd, Kirtland, Ohio |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942780325 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 0034805 (Ohio) | Primary |
| 163W00000X | Registered Nurse | RN.316896 (Ohio) | Secondary |
| Entity Name | Mills Medical Practices Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1477701969 PECOS PAC ID: 4981767597 Enrollment ID: O20090108000186 |
| Entity Name | Signify Health Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1689158487 PECOS PAC ID: 3274895263 Enrollment ID: O20210303002044 |
| Entity Name | Exceptional Care Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245900794 PECOS PAC ID: 5799175741 Enrollment ID: O20221021001400 |
| Entity Name | Abode Care Partners Al Vb Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1104695550 PECOS PAC ID: 1658403704 Enrollment ID: O20240123003907 |
| Entity Name | Provider Partners Care Management Lp |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013348028 PECOS PAC ID: 9335379270 Enrollment ID: O20240411002117 |
| Entity Name | Abode Care Partners Ltc Vb, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1144099318 PECOS PAC ID: 8325316516 Enrollment ID: O20240817000122 |
| Mailing Address | Practice Location Address |
|---|---|
| Mary D Harris, 9685 Chillicothe Rd, Kirtland, OH 44094-8503 Ph: (440) 256-8100 | Mary D Harris, 9685 Chillicothe Rd, Kirtland, OH 44094-8503 Ph: (440) 256-8100 |