Basic Information
| Provider Information | |||||||||
| NPI: | 1942304019 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HARMON | ||||||||
| FirstName: | SHERRY | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | NP, CNM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6626 E 75TH ST | ||||||||
| Address2: | SUITE 500 | ||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462502805 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 333 E COUNTY LINE RD | ||||||||
| Address2: | SUITE B | ||||||||
| City: | GREENWOOD | ||||||||
| State: | IN | ||||||||
| PostalCode: | 461431046 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3174976333 | ||||||||
| FaxNumber: | 3174976334 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/11/2006 | ||||||||
| LastUpdateDate: | 10/12/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/12/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367A00000X | 09000102A | IN | Y | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
ID Information
| ID | Type | State | Issuer | Description | 000000528280 | 01 | IN | ANTHEM | OTHER | 000000654485 | 01 | IN | ANTHEM | OTHER | 200864190 | 05 | IN | MEDICAID |