Provider Demographics
NPI:1811105687
Name:HARDEN, MICHELLE L (EMT-I, MPA)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:L
Last Name:HARDEN
Suffix:
Gender:F
Credentials:EMT-I, MPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1616 CONNOLLY DR
Mailing Address - Street 2:
Mailing Address - City:ELKO
Mailing Address - State:NV
Mailing Address - Zip Code:89801-4773
Mailing Address - Country:US
Mailing Address - Phone:775-219-5162
Mailing Address - Fax:
Practice Address - Street 1:1616 CONNOLLY DR
Practice Address - Street 2:
Practice Address - City:ELKO
Practice Address - State:NV
Practice Address - Zip Code:89801-4773
Practice Address - Country:US
Practice Address - Phone:775-219-5162
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV18097146M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146M00000XEmergency Medical Service ProvidersEmergency Medical Technician, Intermediate
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV18097OtherDEPARTMENT OF HEALTH