Healthcare Provider Details

I. General information

NPI: 1497877757
Provider Name (Legal Business Name): SHERRY LYNN HARMON LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1553 MADISON AVE
MOUNT HEALTHY OH
45231-4466
US

IV. Provider business mailing address

1553 MADISON AVE
MOUNT HEALTHY OH
45231-4466
US

V. Phone/Fax

Practice location:
  • Phone: 513-729-0242
  • Fax:
Mailing address:
  • Phone: 513-729-0242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberPN085223
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: