Provider Demographics
NPI:1255625349
Name:HARMS, BRENDA KAY (RPH)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:KAY
Last Name:HARMS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:943 N LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:NE
Mailing Address - Zip Code:68025-4453
Mailing Address - Country:US
Mailing Address - Phone:402-719-8657
Mailing Address - Fax:
Practice Address - Street 1:818 E 23RD ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NE
Practice Address - Zip Code:68601-3866
Practice Address - Country:US
Practice Address - Phone:402-563-4571
Practice Address - Fax:402-563-3951
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-06
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA18289183500000X
NE15146183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist