Healthcare Provider Details

I. General information

NPI: 1407387020
Provider Name (Legal Business Name): KAMELA ANNETTE HARMON FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2017
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1045 W STEPHENSON ST
FREEPORT IL
61032-4864
US

IV. Provider business mailing address

4439 WESTWIND DR
WINNEBAGO IL
61088-8009
US

V. Phone/Fax

Practice location:
  • Phone: 815-599-6000
  • Fax: 815-599-7974
Mailing address:
  • Phone: 815-971-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209.015764
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209.015764
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: