Provider Demographics
NPI:1982602926
Name:HARMA, MICHELE L (FNP)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:L
Last Name:HARMA
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:N10565 GRANDVIEW LN
Mailing Address - Street 2:
Mailing Address - City:IRONWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:49938-9622
Mailing Address - Country:US
Mailing Address - Phone:906-932-1500
Mailing Address - Fax:906-932-5630
Practice Address - Street 1:501 GRANITE ST
Practice Address - Street 2:
Practice Address - City:HURLEY
Practice Address - State:WI
Practice Address - Zip Code:54534-1384
Practice Address - Country:US
Practice Address - Phone:715-561-2255
Practice Address - Fax:715-561-5021
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704191670363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
1018467OtherPREFERREDONE
MN12D85HAOtherBCBS
WI43903900Medicaid
MI4125540Medicaid
MI4125540Medicaid
500002516Medicare PIN
WI0001Medicare PIN
MI003Medicare PIN