Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 2737 | MN |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 2737 | MN |
NPI | 1255326401 |
---|---|
Provider Name | Deanna E Harter |
First Address | Edina, MN 55436-1530 |
Second Address | Edina, MN 55436-1530 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2005 |
Last Update Date | 22/09/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
706822100 | (05) | MN |
U77439 | (02) |