Provider Demographics
NPI:1780927889
Name:HARMAN, MARIANNE (FNP)
Entity type:Individual
Prefix:MS
First Name:MARIANNE
Middle Name:
Last Name:HARMAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6652 LAKEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:IN
Mailing Address - Zip Code:46368-2404
Mailing Address - Country:US
Mailing Address - Phone:219-928-2905
Mailing Address - Fax:
Practice Address - Street 1:6652 LAKEWOOD AVE
Practice Address - Street 2:CHHABRA MEDICAL CORPORATION PC
Practice Address - City:PORTAGE
Practice Address - State:IN
Practice Address - Zip Code:46368-2404
Practice Address - Country:US
Practice Address - Phone:219-928-2905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-27
Last Update Date:2016-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71004368A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN259780004Medicare PIN