Provider Demographics
NPI:1386967446
Name:HARMER, JEANNE (RN)
Entity type:Individual
Prefix:MS
First Name:JEANNE
Middle Name:
Last Name:HARMER
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 1:3 MELISSA DR
Mailing Address - Street 2:
Mailing Address - City:LAKE GROVE
Mailing Address - State:NY
Mailing Address - Zip Code:11755-2604
Mailing Address - Country:US
Mailing Address - Phone:631-585-5631
Mailing Address - Fax:
Practice Address - Street 1:3 MELISSA DR
Practice Address - Street 2:
Practice Address - City:LAKE GROVE
Practice Address - State:NY
Practice Address - Zip Code:11755-2604
Practice Address - Country:US
Practice Address - Phone:631-585-5631
Practice Address - Fax:631-585-5631
Is Sole Proprietor?:No
Enumeration Date:2010-03-03
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY398835-1163WC1500X, 163WC1600X, 163WE0900X, 163WH0200X, 163WW0000X, 163WX1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development
No163WE0900XNursing Service ProvidersRegistered NurseEnterostomal Therapy
No163WW0000XNursing Service ProvidersRegistered NurseWound Care
No163WX1500XNursing Service ProvidersRegistered NurseOstomy Care