Provider Demographics
NPI:1528530615
Name:BIAS HARRISON, JASANYA DEA
Entity type:Individual
Prefix:
First Name:JASANYA
Middle Name:DEA
Last Name:BIAS HARRISON
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 1:7681 TURNBROOK DR
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21060-8445
Mailing Address - Country:US
Mailing Address - Phone:410-533-9862
Mailing Address - Fax:
Practice Address - Street 1:7681 TURNBROOK DR
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21060-8445
Practice Address - Country:US
Practice Address - Phone:410-533-9862
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-30
Last Update Date:2018-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA000715333747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant