Provider Demographics
NPI:1609605872
Name:HARPER, JODIE SHARECE
Entity type:Individual
Prefix:MRS
First Name:JODIE
Middle Name:SHARECE
Last Name:HARPER
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 1:43 TOWN AND COUNTRY DRIVE
Mailing Address - Street 2:SUITE 119 PMB 151
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22405
Mailing Address - Country:US
Mailing Address - Phone:804-301-5315
Mailing Address - Fax:
Practice Address - Street 1:43 TOWN AND COUNTRY DRIVE
Practice Address - Street 2:SUITE 119 PMB 151
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22405
Practice Address - Country:US
Practice Address - Phone:804-301-5315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier