1033574330 NPI number — MELISSA ROSE HARMON QMAP 171M00000X

Table of content: MELISSA ROSE HARMON QMAP 171M00000X (NPI 1033574330)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033574330 NPI number — MELISSA ROSE HARMON QMAP 171M00000X

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HARMON
Provider First Name:
MELISSA
Provider Middle Name:
ROSE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
QMAP 171M00000X
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033574330
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/08/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5571 US HIGHWAY 20 LOT 1
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WAKEMAN
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44889-9410
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-554-8692
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1234 BELL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AURORA
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80017
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
720-292-8331
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/31/2015

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 171M00000X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com