Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 227609 | TX |
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | R0105058 | OK |
NPI | 1013020643 |
---|---|
Provider Name | Jane M Harmon |
First Address | Broken Bow, OK 74728-6118 |
Second Address | Idabel, OK 74745-4848 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2006 |
Last Update Date | 19/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
124403005 | (05) | TX |
200434630 A | (05) | OK |