Basic Information
| Provider Information | |||||||||
| NPI: | 1144297029 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HARRIS | ||||||||
| FirstName: | RONDA | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | PA C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5615 YORK RD | ||||||||
| Address2: | |||||||||
| City: | NEW OXFORD | ||||||||
| State: | PA | ||||||||
| PostalCode: | 173509553 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7176241337 | ||||||||
| FaxNumber: | 7176241795 | ||||||||
| Practice Location | |||||||||
| Address1: | 5615 YORK RD | ||||||||
| Address2: | |||||||||
| City: | NEW OXFORD | ||||||||
| State: | PA | ||||||||
| PostalCode: | 173509553 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7176241337 | ||||||||
| FaxNumber: | 7176241795 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/01/2006 | ||||||||
| LastUpdateDate: | 01/09/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/09/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | MA051087 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363A00000X | OA000532L | PA | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.