Provider Demographics
NPI:1518284835
Name:HARM, PATRICIA ANN (LPN)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:ANN
Last Name:HARM
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:S2655 STATE ROAD 95
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN CITY
Mailing Address - State:WI
Mailing Address - Zip Code:54629-7601
Mailing Address - Country:US
Mailing Address - Phone:608-687-8222
Mailing Address - Fax:
Practice Address - Street 1:S2655 STATE ROAD 95
Practice Address - Street 2:
Practice Address - City:FOUNTAIN CITY
Practice Address - State:WI
Practice Address - Zip Code:54629-7601
Practice Address - Country:US
Practice Address - Phone:608-687-8222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-26
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WIMUTE1954164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIMUTE1954Medicare Oscar/Certification