Provider Demographics
NPI:1770608234
Name:HARMON, TAMI J (PAC)
Entity type:Individual
Prefix:
First Name:TAMI
Middle Name:J
Last Name:HARMON
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4343 E 31ST PLACE
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85365-4371
Mailing Address - Country:US
Mailing Address - Phone:928-341-4544
Mailing Address - Fax:
Practice Address - Street 1:4343 E 31ST PLACE
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85365-4371
Practice Address - Country:US
Practice Address - Phone:928-341-4544
Practice Address - Fax:928-341-4514
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1893363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZR9244Medicare UPIN