Provider Demographics
NPI:1396847323
Name:HARLAN, JEANNIE LYNN (RN)
Entity Type:Individual
Prefix:
First Name:JEANNIE
Middle Name:LYNN
Last Name:HARLAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7805 LINDSEY DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920
Mailing Address - Country:US
Mailing Address - Phone:719-598-3708
Mailing Address - Fax:
Practice Address - Street 1:REPRODUCTIVE MEDX FERTILITY CENTER
Practice Address - Street 2:3225 INTERNATIONAL SUITE 100
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920
Practice Address - Country:US
Practice Address - Phone:719-475-2229
Practice Address - Fax:719-475-2227
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO121574163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse