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NPI Code Detail

MEDICARE: REBECCA LYN HARNESS

MEDICARE: REBECCA LYN HARNESS
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1871070482
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA LYN HARNESS
Provider Business Mailing Address
First Line : 2052 PRINCETON RD
Second Line :
City : FAIRFIELD TOWNSHIP
State : OH
Zip : 45011-4746
Country : US
Telephone Number : 513-863-6383
Fax Number : 513-863-3772
Provider Business Practice Location Address
First Line : 2052 PRINCETON RD
Second Line :
City : FAIRFIELD TOWNSHIP
State : OH
Zip : 45011-4746
Country : US
Telephone Number : 513-863-6383
Fax Number : 513-863-3772
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2018
Last Update Date : 07/26/2018

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