Provider Demographics
NPI:1295293173
Name:VANCE, HARMONY JEAN (APRN)
Entity type:Individual
Prefix:
First Name:HARMONY
Middle Name:JEAN
Last Name:VANCE
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4908 KLOSTERMAN OAKS BLVD
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34683-1202
Mailing Address - Country:US
Mailing Address - Phone:727-504-4847
Mailing Address - Fax:
Practice Address - Street 1:4442 ORANGE BLOSSOM RD
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34601-7600
Practice Address - Country:US
Practice Address - Phone:727-504-4847
Practice Address - Fax:727-683-9377
Is Sole Proprietor?:No
Enumeration Date:2019-03-09
Last Update Date:2025-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11001711363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL104530400Medicaid
FLCE77POtherFLORIDA BLUE