Healthcare Provider Details

I. General information

NPI: 1063411387
Provider Name (Legal Business Name): KIMBERLY JANE HARMON DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 11/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

217 DUFF AVE STE 2
AMES IA
50010-6609
US

IV. Provider business mailing address

217 DUFF AVE STE 2
AMES IA
50010-6609
US

V. Phone/Fax

Practice location:
  • Phone: 515-233-0943
  • Fax: 515-663-8052
Mailing address:
  • Phone: 515-233-0943
  • Fax: 515-663-8052

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number00664
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: