Healthcare Provider Details

I. General information

NPI: 1013066307
Provider Name (Legal Business Name): JENNIFER HARMON C.S.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JANAYE HARMON SA-C

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 04/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14390 HOPEWELL RD
MILTON GA
30004-6929
US

IV. Provider business mailing address

14390 HOPEWELL RD
MILTON GA
30004-6929
US

V. Phone/Fax

Practice location:
  • Phone: 404-394-0714
  • Fax:
Mailing address:
  • Phone: 404-394-0714
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZS0410X
TaxonomySurgical Technologist
License Number
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: