Basic Information
Provider Information
NPI: 1255633525
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HARMS
FirstName: MARIA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: ANP-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 114 PIPER HILL DR
Address2: SUITE 103
City: SAINT PETERS
State: MO
PostalCode: 633761661
CountryCode: US
TelephoneNumber: 6364425035
FaxNumber: 6364425036
Practice Location
Address1: 114 PIPER HILL DR
Address2: SUITE 103
City: SAINT PETERS
State: MO
PostalCode: 633761661
CountryCode: US
TelephoneNumber: 6364425035
FaxNumber: 6364425036
Other Information
ProviderEnumerationDate: 11/18/2010
LastUpdateDate: 11/18/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2200X2010037296MOY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health

No ID Information.


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