Provider Demographics
NPI:1083604730
Name:HARMON, STANLEY WAYNE (RN, MSN, FNP)
Entity Type:Individual
Prefix:
First Name:STANLEY
Middle Name:WAYNE
Last Name:HARMON
Suffix:
Gender:M
Credentials:RN, MSN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 E CLIFF DR
Mailing Address - Street 2:SUITE 2-A
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-4850
Mailing Address - Country:US
Mailing Address - Phone:915-532-6767
Mailing Address - Fax:915-532-4023
Practice Address - Street 1:1250 E CLIFF DR
Practice Address - Street 2:SUITE 2-A
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-4850
Practice Address - Country:US
Practice Address - Phone:915-532-6767
Practice Address - Fax:915-532-4023
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX601085363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
8D4632Medicare ID - Type Unspecified
Q10445Medicare UPIN