Provider Demographics
NPI:1417107863
Name:HARMON, HEIDI W (FNP)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:W
Last Name:HARMON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 W COLE RD STE 104
Mailing Address - Street 2:
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-9404
Mailing Address - Country:US
Mailing Address - Phone:207-283-1602
Mailing Address - Fax:
Practice Address - Street 1:24 W COLE RD STE 104
Practice Address - Street 2:
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005-9404
Practice Address - Country:US
Practice Address - Phone:207-283-1602
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-23
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAP081952363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME000823001Medicare PIN
ME0008230Medicare PIN
ME000931302Medicare PIN
ME000931301Medicare PIN