Healthcare Provider Details

I. General information

NPI: 1033035480
Provider Name (Legal Business Name): HARVEST HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 W 1ST ST
FAIRMONT MN
56031-1716
US

IV. Provider business mailing address

116 W 1ST ST
FAIRMONT MN
56031-1716
US

V. Phone/Fax

Practice location:
  • Phone: 507-203-9935
  • Fax: 507-203-9936
Mailing address:
  • Phone: 507-203-9935
  • Fax: 507-203-9936

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LORI ANN FETT
Title or Position: OWNER
Credential:
Phone: 507-831-2500