Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 00664 | IA |
Y | 222Z00000X | Podiatrist | 00664 | IA |
NPI | 1063411387 |
---|---|
Provider Name | Dr. Kimberly Jane Harmon |
First Address | Ames, IA 50010-6609 |
Second Address | Ames, IA 50010-6609 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2005 |
Last Update Date | 01/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
20196 | BLUE CROSS/BLUE SHIELD (01) | IA |
2168591 | (05) | IA |
480030395 | RAILROAD MEDICARE (01) | IA |
U70500 | (02) |