Provider Demographics
NPI:1992367486
Name:HARMON, EMILY
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:HARMON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12050 MADISON RD
Mailing Address - Street 2:
Mailing Address - City:HUNTSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44046-9713
Mailing Address - Country:US
Mailing Address - Phone:330-646-5809
Mailing Address - Fax:
Practice Address - Street 1:17792 REYNOLDS RD
Practice Address - Street 2:
Practice Address - City:WEST FARMINGTON
Practice Address - State:OH
Practice Address - Zip Code:44491-9618
Practice Address - Country:US
Practice Address - Phone:330-646-5809
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-03
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0235172Medicaid