Healthcare Provider Details

I. General information

NPI: 1508558792
Provider Name (Legal Business Name): JESSICA HARBAUER PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2023
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 E 680 S
CEDAR CITY UT
84720-3593
US

IV. Provider business mailing address

474 W 200 N # 300
ST GEORGE UT
84770-4505
US

V. Phone/Fax

Practice location:
  • Phone: 435-867-7654
  • Fax: 435-867-7699
Mailing address:
  • Phone: 435-634-5600
  • Fax: 435-634-8700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number875603
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: