MEDICARE: MRS. MARY HELEN HARMYCH FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	1-184242	AL
2	363LF0000X	Family Nurse Practitioner	COA.16317-NP	OH

General Provider Information

NPI Number	:	1295136315
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARY HELEN HARMYCH FNP-BC

Provider Business Mailing Address
First Line	:	30 BURTON HILLS BLVD
Second Line	:	STE 175
City	:	NASHVILLE
State	:	TN
Zip	:	37215-6403
Country	:	US
Telephone Number	:	615-988-2014
Fax Number	:	615-208-1303

Provider Business Practice Location Address
First Line	:	2601 AQUA MARINE BLVD
Second Line	:
City	:	AVON LAKE
State	:	OH
Zip	:	44012-2640
Country	:	US
Telephone Number	:	440-382-8543
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/08/2014
Last Update Date	:	03/18/2021

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