Provider Demographics
NPI:1033898051
Name:HARP, NOVA JEAN (LPN)
Entity Type:Individual
Prefix:
First Name:NOVA
Middle Name:JEAN
Last Name:HARP
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:468757 E 1113 LOOP LOT 16
Mailing Address - Street 2:
Mailing Address - City:GANS
Mailing Address - State:OK
Mailing Address - Zip Code:74936-5025
Mailing Address - Country:US
Mailing Address - Phone:918-232-6960
Mailing Address - Fax:
Practice Address - Street 1:619 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MUSKOGEE
Practice Address - State:OK
Practice Address - Zip Code:74401-4431
Practice Address - Country:US
Practice Address - Phone:918-682-8407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKL0056150164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse