Provider Demographics
NPI:1942499421
Name:HARMS, KATHERINE MAE (RN)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:MAE
Last Name:HARMS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3407 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53405-2908
Mailing Address - Country:US
Mailing Address - Phone:262-717-9850
Mailing Address - Fax:262-717-9851
Practice Address - Street 1:20700 WATERTOWN RD
Practice Address - Street 2:SUITE 101
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53186-1800
Practice Address - Country:US
Practice Address - Phone:262-717-9850
Practice Address - Fax:262-717-9851
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-19
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse