Provider Demographics
NPI:1356555064
Name:HARPER, JANE ELIZABETH (OTR)
Entity type:Individual
Prefix:MS
First Name:JANE
Middle Name:ELIZABETH
Last Name:HARPER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2638 LONGVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40206-2555
Mailing Address - Country:US
Mailing Address - Phone:502-387-0062
Mailing Address - Fax:
Practice Address - Street 1:1410 LONG RUN RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40245-4334
Practice Address - Country:US
Practice Address - Phone:502-244-8011
Practice Address - Fax:502-244-6631
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR0719225XP0200X
KY132403225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY02025OtherFIRST STEPS PROVIDER
KY01049004Medicare PIN