Provider Demographics
NPI:1689642225
Name:HARKIN, MARY B (NP)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:B
Last Name:HARKIN
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:354 MOUNTAIN VIEW DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:COLCHESTER
Mailing Address - State:VT
Mailing Address - Zip Code:05446-5988
Mailing Address - Country:US
Mailing Address - Phone:802-864-0192
Mailing Address - Fax:802-860-4919
Practice Address - Street 1:354 MOUNTAIN VIEW DR
Practice Address - Street 2:SUITE 300
Practice Address - City:COLCHESTER
Practice Address - State:VT
Practice Address - Zip Code:05446-5988
Practice Address - Country:US
Practice Address - Phone:802-864-0192
Practice Address - Fax:802-860-4919
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2013-09-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VT1010016091207N00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NP3129Medicare ID - Type Unspecified
P27638Medicare UPIN