Provider Demographics
NPI:1417903576
Name:HARKREADER, JAMES ROBERT (FNP)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ROBERT
Last Name:HARKREADER
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 PATTERSON RD
Mailing Address - Street 2:PO BOX 62
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81506-8219
Mailing Address - Country:US
Mailing Address - Phone:970-298-2001
Mailing Address - Fax:970-298-7042
Practice Address - Street 1:1100 PATTERSON RD
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81506-8219
Practice Address - Country:US
Practice Address - Phone:970-298-2001
Practice Address - Fax:970-298-7042
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO71129363LF0000X, 363LX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
500003970OtherRAILROAD
CO7711294Medicaid
UTT0109Medicaid
COR18735Medicare UPIN
CO7711294Medicaid