Provider Demographics
NPI:1033472832
Name:HARZMAN, CONNIE L (ARNP)
Entity Type:Individual
Prefix:
First Name:CONNIE
Middle Name:L
Last Name:HARZMAN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2318 E CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67214-4436
Mailing Address - Country:US
Mailing Address - Phone:316-262-2415
Mailing Address - Fax:316-262-0741
Practice Address - Street 1:935 N MARKET ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-3521
Practice Address - Country:US
Practice Address - Phone:316-858-1151
Practice Address - Fax:316-858-1152
Is Sole Proprietor?:No
Enumeration Date:2012-06-18
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS51757163W00000X
KSTMP 145036363LF0000X
KS75833363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse