Provider Demographics
NPI:1639276942
Name:HARMON, JOHN O (CRNA)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:O
Last Name:HARMON
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2130 E WYOMING DR
Mailing Address - Street 2:
Mailing Address - City:SAINT GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-2204
Mailing Address - Country:US
Mailing Address - Phone:801-787-2827
Mailing Address - Fax:
Practice Address - Street 1:1490 E FOREMASTER DR
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790
Practice Address - Country:US
Practice Address - Phone:702-489-5460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2018-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT262390-4406367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT32558OtherHEALTHY U
UT819880OtherDESERET MUTUAL
UT107022229101OtherIHC
UTQM0000054865OtherALTIUS
UT26239044000001OtherBCBS
UT190683600OtherUS DEPT OF LABOR
UT870666269HA4OtherEDUCATORS MUTUAL
UTTPRA08584OtherMOLINA
UT74824OtherPEHP
UT870666269HA4OtherEDUCATORS MUTUAL
UT005589125Medicare PIN