Provider Demographics
NPI:1841991668
Name:HARMS, KATHY LYNN (RN)
Entity type:Individual
Prefix:
First Name:KATHY
Middle Name:LYNN
Last Name:HARMS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 VIA GETRUDITAS LOOP
Mailing Address - Street 2:
Mailing Address - City:PECOS
Mailing Address - State:NM
Mailing Address - Zip Code:87552-2509
Mailing Address - Country:US
Mailing Address - Phone:505-757-6006
Mailing Address - Fax:
Practice Address - Street 1:141 E BOOTH ST
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-2617
Practice Address - Country:US
Practice Address - Phone:505-467-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-17
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR57423163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool