Provider Demographics
NPI:1184027500
Name:HARMON, LILY (FNP)
Entity Type:Individual
Prefix:
First Name:LILY
Middle Name:
Last Name:HARMON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:LILY
Other - Middle Name:O
Other - Last Name:HARMON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:2261 PHILADELPHIA DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45406-1126
Mailing Address - Country:US
Mailing Address - Phone:937-734-4141
Mailing Address - Fax:
Practice Address - Street 1:2261 PHILADELPHIA DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45406-1126
Practice Address - Country:US
Practice Address - Phone:937-734-4141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-30
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.16612-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily