Healthcare Provider Details

I. General information

NPI: 1477602092
Provider Name (Legal Business Name): SHELLEY A HARMONY R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 07/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7440 WASHINGTON VILLAGE DR. SUITE 130
CENTERVILLE OH
45459
US

IV. Provider business mailing address

2912 SPRINGBORO W SUITE 201
MORAINE OH
45439-1674
US

V. Phone/Fax

Practice location:
  • Phone: 937-433-8060
  • Fax: 937-433-8066
Mailing address:
  • Phone: 937-297-8999
  • Fax: 937-396-0045

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN-185337
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163WC2100X
TaxonomyContinence Care Registered Nurse
License NumberRN-185337
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License NumberRN-185337
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code163WX1500X
TaxonomyOstomy Care Registered Nurse
License NumberRN-185337
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: