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NPI Code Detail

MEDICARE: MS. LOLITA IZETT HARMON FNP-BC

MEDICARE: MS. LOLITA IZETT HARMON 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
1163WE0003XEmergency Registered NurseRN142204GA
2363LF0000XFamily Nurse Practitioner71010570AIN

General Provider Information

NPI Number : 1710171707
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LOLITA IZETT HARMON FNP-BC
Provider Business Mailing Address
First Line : 6451 ARTHUR ST
Second Line :
City : MERRILLVILLE
State : IN
Zip : 46410-3122
Country : US
Telephone Number : 269-208-3356
Fax Number :
Provider Business Practice Location Address
First Line : 1619 W 5TH AVE
Second Line :
City : GARY
State : IN
Zip : 46404-1506
Country : US
Telephone Number : 219-886-4788
Fax Number : 219-886-4106
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2007
Last Update Date : 05/13/2025

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