Provider Demographics
NPI:1992736342
Name:HARMER, ELIZABETH M (CNM)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:M
Last Name:HARMER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1248 E 90 N
Mailing Address - Street 2:STE 300
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003-2956
Mailing Address - Country:US
Mailing Address - Phone:801-756-1577
Mailing Address - Fax:801-216-8357
Practice Address - Street 1:1248 E 90 N
Practice Address - Street 2:STE 300
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-2956
Practice Address - Country:US
Practice Address - Phone:801-756-1577
Practice Address - Fax:801-216-8357
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT3343084404367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
P88719Medicare UPIN
004880056Medicare ID - Type Unspecified