Healthcare Provider Details

I. General information

NPI: 1992342992
Provider Name (Legal Business Name): FELISHA MARIE HARMON APRN-BC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2019
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

607 NORTH AVE OFC 18
WAKEFIELD MA
01880-1322
US

IV. Provider business mailing address

9793 W SAMPLE RD
CORAL SPRINGS FL
33065-4003
US

V. Phone/Fax

Practice location:
  • Phone: 781-705-0567
  • Fax: 623-666-6792
Mailing address:
  • Phone: 781-705-0567
  • Fax: 623-666-6792

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SEFELISHA MARIE HARMON
Title or Position: PRESIDENT
Credential: APRN
Phone: 773-649-0759