Provider Demographics
NPI:1730136417
Name:HARMSEN, NORA KAY (DDS)
Entity Type:Individual
Prefix:DR
First Name:NORA
Middle Name:KAY
Last Name:HARMSEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 630069
Mailing Address - Street 2:730 LANAI AVE., STE #101
Mailing Address - City:LANAI CITY
Mailing Address - State:HI
Mailing Address - Zip Code:96763-0069
Mailing Address - Country:US
Mailing Address - Phone:808-565-6418
Mailing Address - Fax:808-565-6742
Practice Address - Street 1:730 LANAI AVENUE
Practice Address - Street 2:SUITE #101
Practice Address - City:LANAI CITY
Practice Address - State:HI
Practice Address - Zip Code:96763-0069
Practice Address - Country:US
Practice Address - Phone:808-565-6418
Practice Address - Fax:808-565-6742
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT1969122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI496366Medicaid