Provider Demographics
NPI:1639283302
Name:HARMSTON, CATHERINE M (FNP)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:M
Last Name:HARMSTON
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 1:838 E 6600 S
Mailing Address - Street 2:
Mailing Address - City:UINTAH
Mailing Address - State:UT
Mailing Address - Zip Code:84405-9701
Mailing Address - Country:US
Mailing Address - Phone:801-660-5466
Mailing Address - Fax:
Practice Address - Street 1:220 BANNOCK ST
Practice Address - Street 2:
Practice Address - City:MALAD CITY
Practice Address - State:ID
Practice Address - Zip Code:83252-5068
Practice Address - Country:US
Practice Address - Phone:208-766-2600
Practice Address - Fax:208-766-4258
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID59987363LF0000X
UT223876-4405363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner