Provider Demographics
NPI:1861470031
Name:HARMS, MARK E (PA)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:E
Last Name:HARMS
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 S 9TH ST
Mailing Address - Street 2:
Mailing Address - City:HUMBOLDT
Mailing Address - State:KS
Mailing Address - Zip Code:66748-1908
Mailing Address - Country:US
Mailing Address - Phone:620-473-2275
Mailing Address - Fax:620-473-2821
Practice Address - Street 1:202 S 9TH ST
Practice Address - Street 2:
Practice Address - City:HUMBOLDT
Practice Address - State:KS
Practice Address - Zip Code:66748-1908
Practice Address - Country:US
Practice Address - Phone:620-473-2275
Practice Address - Fax:620-473-2821
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS15-00078363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS384520OtherFIRSTGUARD
KSP00182773OtherRAILROAD MEDICARE
KSP00182773OtherRAILROAD MEDICARE
R30907Medicare UPIN