Provider Demographics
NPI:1245802040
Name:HARP, ERNEST L (FNP-BC)
Entity Type:Individual
Prefix:
First Name:ERNEST
Middle Name:L
Last Name:HARP
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1932 SEVERN RD
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48236-1961
Mailing Address - Country:US
Mailing Address - Phone:313-702-1911
Mailing Address - Fax:586-799-1216
Practice Address - Street 1:15959 HALL RD STE LL104
Practice Address - Street 2:
Practice Address - City:MACOMB
Practice Address - State:MI
Practice Address - Zip Code:48044-5364
Practice Address - Country:US
Practice Address - Phone:313-702-1911
Practice Address - Fax:586-799-1216
Is Sole Proprietor?:No
Enumeration Date:2021-07-13
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704260783363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily