Provider Demographics
NPI:1497435135
Name:HARMON, STEPHANIE ANTOINETTE
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ANTOINETTE
Last Name:HARMON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2249 E APPLE AVE APT 8
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49442-4379
Mailing Address - Country:US
Mailing Address - Phone:231-672-5095
Mailing Address - Fax:
Practice Address - Street 1:2249 E APPLE AVE APT 8
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49442-4379
Practice Address - Country:US
Practice Address - Phone:231-672-5095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-18
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula