Healthcare Provider Details

I. General information

NPI: 1346979549
Provider Name (Legal Business Name): SANDRA LOU HARMON MSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2022
Last Update Date: 06/06/2022
Certification Date: 06/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 GRANT ST
FRAMINGHAM MA
01702-6764
US

IV. Provider business mailing address

9 INDEPENDENCE WAY APT 106
FRANKLIN MA
02038-7314
US

V. Phone/Fax

Practice location:
  • Phone: 508-521-2200
  • Fax:
Mailing address:
  • Phone: 508-431-0329
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberRN142540
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: