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NPI Code Detail

MEDICARE: MRS. KIMBERLY NICOLE HARMON

MEDICARE: MRS. KIMBERLY NICOLE HARMON
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
1172V00000XCommunity Health Worker

General Provider Information

NPI Number : 1902738305
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KIMBERLY NICOLE HARMON
Provider Business Mailing Address
First Line : 1495 OAK TER
Second Line :
City : SAINT JOSEPH
State : MI
Zip : 49085-9722
Country : US
Telephone Number : 269-326-0701
Fax Number :
Provider Business Practice Location Address
First Line : 2900 LAKEVIEW AVE
Second Line :
City : SAINT JOSEPH
State : MI
Zip : 49085-2379
Country : US
Telephone Number : 269-408-4368
Fax Number : 269-408-4368
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2026
Last Update Date : 06/01/2026

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Directions to “ MRS. KIMBERLY NICOLE HARMON ” Practice Location

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