Provider Demographics
NPI:1194011015
Name:HARMS, KAYLENE ANN (DDS)
Entity Type:Individual
Prefix:DR
First Name:KAYLENE
Middle Name:ANN
Last Name:HARMS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 1ST ST
Mailing Address - Street 2:
Mailing Address - City:CRAWFORD
Mailing Address - State:NE
Mailing Address - Zip Code:69339-1186
Mailing Address - Country:US
Mailing Address - Phone:402-640-4521
Mailing Address - Fax:
Practice Address - Street 1:705 1ST ST
Practice Address - Street 2:
Practice Address - City:CRAWFORD
Practice Address - State:NE
Practice Address - Zip Code:69339-1186
Practice Address - Country:US
Practice Address - Phone:402-640-4521
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-20
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE6962122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist