Provider Demographics
NPI:1235642281
Name:HARMON, MARY KATHERINE (APRN-CNP, WHNP-BC)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:KATHERINE
Last Name:HARMON
Suffix:
Gender:F
Credentials:APRN-CNP, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10278 HAZY GLEN DR
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83687-7934
Mailing Address - Country:US
Mailing Address - Phone:949-547-3285
Mailing Address - Fax:
Practice Address - Street 1:1181 S SILVERSTONE WAY STE 100
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-1281
Practice Address - Country:US
Practice Address - Phone:208-490-5464
Practice Address - Fax:208-747-1289
Is Sole Proprietor?:No
Enumeration Date:2017-11-13
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95007802363LW0102X
ID2271450363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health