Provider Demographics
NPI:1780617084
Name:HARMAN, SHARI SUZANNE (FNPC)
Entity type:Individual
Prefix:MS
First Name:SHARI
Middle Name:SUZANNE
Last Name:HARMAN
Suffix:
Gender:F
Credentials:FNPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N2353 FEN LOCKNEY DRIVE
Mailing Address - Street 2:
Mailing Address - City:LACROSSE
Mailing Address - State:WI
Mailing Address - Zip Code:54601
Mailing Address - Country:US
Mailing Address - Phone:507-457-5160
Mailing Address - Fax:507-457-2326
Practice Address - Street 1:101 E WABASHA
Practice Address - Street 2:WINONA STATE UNIVERSITY STUDENT HEALTH CENTER
Practice Address - City:WINONA
Practice Address - State:MN
Practice Address - Zip Code:55987-5838
Practice Address - Country:US
Practice Address - Phone:507-457-5160
Practice Address - Fax:507-457-2326
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2007-07-24
Deactivation Date:2007-07-17
Deactivation Code:
Reactivation Date:2007-07-24
Provider Licenses
StateLicense IDTaxonomies
MNR0770152363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43889800Medicaid