MEDICARE: MRS. MISCHELLE LINDA HARMON CRNA

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	367500000X	Certified Registered Nurse Anesthetist	RN79312	TN
2	367500000X	Certified Registered Nurse Anesthetist	936684	NY
3	367500000X	Certified Registered Nurse Anesthetist	1066139	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801882170
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MISCHELLE LINDA HARMON CRNA

Provider Business Mailing Address
First Line	:	70 RAINEY ST APT 1304
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78701-4739
Country	:	US
Telephone Number	:	256-777-9158
Fax Number	:

Provider Business Practice Location Address
First Line	:	1425 PORTLAND AVE
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14621-3095
Country	:	US
Telephone Number	:	585-922-4159
Fax Number	:	585-922-3731

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

Provider Enumeration Date	:	09/22/2005
Last Update Date	:	04/17/2025

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